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三级护理医院新生儿重症监护病房的新鲜冰冻血浆和血小板输注实践

Fresh Frozen Plasma and Platelet Transfusion Practices in Neonatal Intensive Care Unit of a Tertiary Care Hospital.

作者信息

Dogra Kanchan, Kaur Gagandeep, Basu Sabita, Chawla Deepak

机构信息

1Department of Transfusion Medicine, AIIMS, New Delhi, India.

2Department of Transfusion Medicine, GMCH, Sector-32, Chandigarh, India.

出版信息

Indian J Hematol Blood Transfus. 2020 Jan;36(1):141-148. doi: 10.1007/s12288-019-01164-z. Epub 2019 Jul 30.

Abstract

Blood transfusion is an indispensable part of modern medical and surgical practices. More than 35% of critically ill patients receive transfusion of blood components during their intensive care unit stay. The aim of study is to obtain an information regarding the relationship of platelet concentrate (PC) and fresh frozen plasma (FFP) transfusion on clinical outcome of neonates admitted in neonatal ICU (NICU). This prospective cohort study was conducted from 1st November 2011 to 30th April 2013. The clinical history, blood component details and laboratory parameters were evaluated with clinical outcome. The neonates requiring PC and FFP transfusion were followed up in blood bank for laboratory parameters. Clinical parameters were noted from case file. During the study period, 291 neonates were admitted in NICU. 2 neonates had congenital malformations and thus, were excluded from the study. Of the remaining 289 neonates, 49 neonates received transfusion of platelets and/or FFP. The combined mean donor exposure for all components was found to be 1.48. The mean volume of PC and FFP transfused was 20 ml and 30 ml respectively. The mean pre- and post-transfusion platelet count was 34,000 µl and 42,000 µl respectively. The mean pre- and post-transfusion INR was 2.37 and 1.53 respectively. There was a significant increase in platelet count and decrease in INR in transfused neonates. However, no clinical benefit of PC and FFP transfusion seen on bleeding. Transfusion of PC and FFP has significant effect on laboratory parameters as compared to clinical parameter.

摘要

输血是现代医学和外科手术中不可或缺的一部分。超过35%的重症患者在重症监护病房住院期间接受血液成分输血。本研究的目的是获取有关新生儿重症监护病房(NICU)中浓缩血小板(PC)和新鲜冰冻血浆(FFP)输血与新生儿临床结局之间关系的信息。这项前瞻性队列研究于2011年11月1日至2013年4月30日进行。对临床病史、血液成分细节和实验室参数与临床结局进行了评估。对需要输注PC和FFP的新生儿在血库进行实验室参数随访。从病例档案中记录临床参数。在研究期间,291名新生儿入住NICU。2名新生儿患有先天性畸形,因此被排除在研究之外。在其余289名新生儿中,49名新生儿接受了血小板和/或FFP输血。发现所有成分的合并平均供体暴露为1.48。PC和FFP的平均输血量分别为20毫升和30毫升。输血前和输血后血小板计数的平均值分别为34,000/微升和42,000/微升。输血前和输血后INR的平均值分别为2.37和1.53。输血新生儿的血小板计数显著增加,INR降低。然而,未观察到PC和FFP输血对出血有临床益处。与临床参数相比,PC和FFP输血对实验室参数有显著影响。

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Platelet Transfusion Practices Among Very-Low-Birth-Weight Infants.极低出生体重儿的血小板输注实践
JAMA Pediatr. 2016 Jul 1;170(7):687-94. doi: 10.1001/jamapediatrics.2016.0507.
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Clinical use of fresh-frozen plasma in neonatal intensive care unit.新鲜冰冻血浆在新生儿重症监护病房的临床应用
Transfus Apher Sci. 2012 Aug;47(1):91-4. doi: 10.1016/j.transci.2012.05.007. Epub 2012 May 27.

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