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COVID-19 疫情及封控措施对输血的影响。

Impact of COVID-19 and lockdown regarding blood transfusion.

机构信息

Anaesthesia, Intensive Care and Perioperative Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.

Établissement Français du Sang Grand-Est, site de Strasbourg, Strasbourg, France.

出版信息

Transfusion. 2021 Aug;61(8):2327-2335. doi: 10.1111/trf.16422. Epub 2021 Jul 13.

Abstract

BACKGROUND

The outbreak of a SARS-CoV-2 resulted in a massive afflux of patients in hospital and intensive care units with many challenges. Blood transfusion was one of them regarding both blood banks (safety, collection, and stocks) and consumption (usual care and unknown specific demand of COVID-19 patients). The risk of mismatch was sufficient to plan blood transfusion restrictions if stocks became limited.

STUDY DESIGN AND METHODS

Analyses of blood transfusion in a tertiary hospital and blood collection in the referring blood bank between February 24 and May 31, 2020.

RESULTS

Withdrawal of elective surgery and non-urgent care and admission of 2291 COVID-19 patients reduced global activity by 33% but transfusion by 17% only. Only 237 (10.3) % of COVID-19 patients required blood transfusion, including 45 (2.0%) with acute bleeding. Lockdown and cancellation of mobile collection resulted in an 11% reduction in blood donation compared to 2019. The ratio of reduction in blood transfusion to blood donation remained positive and stocks were slightly enhanced.

DISCUSSION

Reduction of admissions due to SARS-CoV-2 pandemic results only in a moderate decrease of blood transfusion. Incompressible blood transfusions concern urgent surgery, acute bleeding (including some patients with COVID-19, especially under high anticoagulation), or are supportive for chemotherapy-induced aplasia or chronic anemia. Lockdown results in a decrease of blood donation by cancellation of mobile donation but with little impact on a short period by mobilization of usual donors. No mismatch between demand and donation was evidenced and no planned restriction to blood transfusion was necessary.

摘要

背景

SARS-CoV-2 的爆发导致医院和重症监护病房涌入大量患者,带来了许多挑战。输血就是其中之一,无论是血库(安全性、采集和库存)还是输血需求(常规护理和 COVID-19 患者的未知特殊需求)。如果库存有限,不匹配的风险足以计划限制输血。

研究设计和方法

分析了 2020 年 2 月 24 日至 5 月 31 日期间一家三级医院的输血情况和转诊血库的采血情况。

结果

选择性手术和非紧急护理的取消以及 2291 例 COVID-19 患者的入院使整体活动减少了 33%,但仅减少了 17%的输血。仅 237(10.3)%的 COVID-19 患者需要输血,包括 45(2.0%)例急性出血。封锁和取消流动采血导致与 2019 年相比,献血量减少了 11%。输血减少与献血减少的比例保持为正,库存略有增加。

讨论

由于 SARS-CoV-2 大流行导致的入院人数减少仅导致输血适度减少。不可压缩的输血涉及紧急手术、急性出血(包括一些 COVID-19 患者,尤其是在高抗凝状态下)或支持化疗诱导的再生障碍或慢性贫血。封锁导致流动献血取消,献血量减少,但通过动员常规献血者,在短时间内影响不大。需求与献血之间没有不匹配的证据,也没有必要计划限制输血。

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