University of Maryland School of Medicine, Baltimore, MD, USA.
Am J Surg. 2020 Sep;220(3):580-588. doi: 10.1016/j.amjsurg.2020.05.008. Epub 2020 May 11.
Resuscitation of the critically ill patient with fluid and blood products is one of the most widespread interventions in medicine. This is especially relevant for trauma patients, as hemorrhagic shock remains the most common cause of preventable death after injury. Consequently, the study of the ideal resuscitative product for patients in shock has become an area of great scientific interest and investigation. Recently, the pendulum has swung towards increased utilization of blood products for resuscitation. However, pathogens, immune reactions and the limited availability of this resource remain a challenge for clinicians. Technologic advances in pathogen reduction and innovations in blood product processing will allow us to increase the safety profile and efficacy of blood products, ultimately to the benefit of patients. The purpose of this article is to review the current state of blood product based resuscitative strategies as well as technologic advancements that may lead to safer resuscitation.
对危重症患者进行液体和血液制品复苏是医学中最广泛的干预措施之一。这对于创伤患者尤其重要,因为出血性休克仍然是创伤后可预防死亡的最常见原因。因此,研究休克患者的理想复苏产品已成为一个极具科学意义和研究价值的领域。最近,人们越来越倾向于使用血液制品进行复苏。然而,病原体、免疫反应以及这种资源的有限供应仍然是临床医生面临的挑战。病原体减少的技术进步和血液制品处理方面的创新将使我们能够提高血液制品的安全性和疗效,最终使患者受益。本文的目的是回顾基于血液制品的复苏策略的现状,以及可能导致更安全复苏的技术进步。