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红细胞输注对末梢毛细血管血氧饱和度和动脉血氧分压的影响。

Impact of RBC Transfusion on Peripheral Capillary Oxygen Saturation and Partial Pressure of Arterial Oxygen.

机构信息

Department of Pathology and Laboratory Medicine, Transfusion Medicine Division, University of Rochester Medical Center, Rochester, NY.

出版信息

Am J Clin Pathol. 2021 Jun 17;156(1):149-154. doi: 10.1093/ajcp/aqaa219.

Abstract

OBJECTIVES

RBCs are known to undergo deleterious changes during storage, known as storage lesions, which have been shown to result in decreased oxygen-carrying capacity. However, there is inadequate literature describing the effects of stored RBC allogeneic transfusion on oxygen parameters in vivo. The oxygen standard parameters were retrospectively assessed before and after RBC transfusion.

METHODS

Patients who received 1 RBC transfusion were assessed for hemoglobin (Hb) levels, peripheral capillary oxygen saturation (Spo2), and partial pressure of arterial oxygen (Pao2) from 12 hours before and 24 hours after transfusion.

RESULTS

In total, 78 patients who were monitored by Spo2 and 28 patients monitored by Pao2 were included in this analysis. Following RBC transfusion, Hb levels increased significantly (P < .001); however, there was a significant decrease in both Spo2 and Pao2 within 24 hours after transfusion (P = .04 and P = .003, respectively), indicating lower tissue oxygenation and lower soluble oxygen level.

CONCLUSIONS

This single-center, retrospective study revealed evidence of significantly decreased oxygenation and tissue perfusion after single-unit RBC transfusion, despite corrected Hb levels.

摘要

目的

众所周知,红细胞在储存过程中会发生有害变化,称为储存损伤,这会导致携氧能力下降。然而,目前关于储存的异体 RBC 输血对体内氧参数的影响的文献还不够充分。本研究回顾性评估了输血前后红细胞的氧标准参数。

方法

对接受 1 单位 RBC 输血的患者,在输血前 12 小时和输血后 24 小时,评估血红蛋白(Hb)水平、外周毛细血管血氧饱和度(Spo2)和动脉血氧分压(Pao2)。

结果

本研究共纳入了 78 例接受 Spo2 监测的患者和 28 例接受 Pao2 监测的患者。输血后 Hb 水平显著升高(P<0.001);然而,输血后 24 小时内 Spo2 和 Pao2 均显著下降(P=0.04 和 P=0.003),表明组织氧合和可溶性氧水平降低。

结论

本单中心回顾性研究表明,尽管 Hb 水平得到纠正,但单次输注单位 RBC 后,氧合和组织灌注明显下降。

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