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急性烧伤患者贫血的治疗:输血实践研究

Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices.

作者信息

Tichil Ioana, Rosenblum Samara, Paul Eldho, Cleland Heather

机构信息

Department of Oncology and Haematology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 73 21 December Boulevard, 400603 Cluj-Napoca, Romania.

Department of Anatomy and Embryology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2021 Jan 27;10(3):476. doi: 10.3390/jcm10030476.

DOI:10.3390/jcm10030476
PMID:33514060
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7865424/
Abstract

: To determine blood transfusion practices, risk factors, and outcomes associated with the use of blood products in the setting of the acute management of burn patients at the Victorian Adult Burn Service. : Patients with burn injuries have variable transfusion requirements, based on a multitude of factors. We reviewed all acute admissions to the Victorian Adult Burns Service (VABS) between 2011 and 2017: 1636 patients in total, of whom 948 had surgery and were the focus of our analysis. : Patient demographics, surgical management, transfusion details, and outcome parameters were collected and analyzed. A total of 175 patients out of the 948 who had surgery also had a blood transfusion, while 52% of transfusions occurred in the perioperative period. The median trigger haemoglobin in perioperative was 80mg/dL (IQR = 76-84.9 mg/dL), and in the non-perioperative setting was 77 mg/dL (IQR = 71.61-80.84 mg/dL). Age, gender, % total body surface area (TBSA) burn, number of surgeries, and intensive care unit and hospital length of stay were associated with transfusion. : The use of blood transfusions is an essential component of the surgical management of major burns. As observed in our study, half of these transfusions are related to surgical procedures and may be influenced by the employment of blood conserving strategies. Furthermore, transfusion trigger levels in stable patients may be amenable to review and reduction. Risk adjusted analysis can support the implementation of blood transfusion as a useful quality indicator in burn care.

摘要

目的

确定在维多利亚成人烧伤服务中心对烧伤患者进行急性处理时使用血液制品的输血实践、风险因素及相关结果。

研究对象

烧伤患者的输血需求因多种因素而异。我们回顾了2011年至2017年间维多利亚成人烧伤服务中心(VABS)的所有急性入院患者:共计1636例患者,其中948例接受了手术,是我们分析的重点。

研究方法

收集并分析患者的人口统计学资料、手术管理情况、输血细节及结果参数。948例接受手术的患者中,共有175例也接受了输血,其中52%的输血发生在围手术期。围手术期的血红蛋白触发阈值中位数为80mg/dL(四分位间距=76-84.9mg/dL),非围手术期为77mg/dL(四分位间距=71.61-80.84mg/dL)。年龄、性别、烧伤总面积百分比(TBSA)、手术次数、重症监护病房及住院时间与输血相关。

研究结论

输血是大面积烧伤手术治疗的重要组成部分。如我们的研究所示,这些输血中有一半与手术操作有关,可能会受到血液保护策略应用的影响。此外,稳定患者的输血触发水平可能需要重新评估并降低。风险调整分析可支持将输血作为烧伤护理中一个有用的质量指标来实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/c7c4c1d617a7/jcm-10-00476-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/2643a73c5174/jcm-10-00476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/00f0772e546a/jcm-10-00476-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/c7c4c1d617a7/jcm-10-00476-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/2643a73c5174/jcm-10-00476-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/00f0772e546a/jcm-10-00476-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7865424/c7c4c1d617a7/jcm-10-00476-g003.jpg

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本文引用的文献

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Iron Deficiency in Chronic Kidney Disease: Updates on Pathophysiology, Diagnosis, and Treatment.慢性肾脏病中的缺铁:病理生理学、诊断和治疗的最新进展。
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Iron deficiency: an independent prognostic marker in heart failure.缺铁:心力衰竭的独立预后标志物。
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