Farrell Michael S, Kim Woon Cho, Stein Deborah M
Department of Surgery, University of California San Francisco, 1001 Potrero Avenue, Ward 3A, San Francisco, CA 94110, USA; Zuckerberg San Francisco General Hospital, San Francisco, CA, USA. Electronic address: https://twitter.com/mfarrellmd.
Department of Surgery, University of California San Francisco, 1001 Potrero Avenue, Ward 3A, San Francisco, CA 94110, USA; Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
Emerg Med Clin North Am. 2020 Nov;38(4):795-805. doi: 10.1016/j.emc.2020.06.005. Epub 2020 Jul 21.
Successful emergency transfusions require early recognition and activation of resources to minimize treatment delays. The initial goals should focus on replacement of blood in a balanced fashion. There is an ongoing debate regarding the best approach to transfusions, with some advocating for resuscitation with a fixed ratio of blood products and others preferring to use viscoelastic assays to guide transfusions. Whole-blood transfusion also is a debated strategy. Despite these different approaches, it generally is accepted that transfusions should be started early and crystalloid infusions limited. As hemodynamic stability is restored, endpoints of resuscitation should be used to guide the resuscitation.
成功的紧急输血需要早期识别并启动资源，以尽量减少治疗延误。初始目标应侧重于以平衡的方式补充血液。关于输血的最佳方法存在持续的争论，一些人主张按固定比例的血液制品进行复苏，另一些人则倾向于使用粘弹性检测来指导输血。全血输血也是一种有争议的策略。尽管有这些不同的方法，但人们普遍认为输血应尽早开始，晶体液输注应受到限制。随着血流动力学稳定性的恢复，应使用复苏终点来指导复苏。
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