大量输血与胎儿结局相关的风险感知：对一家美国创伤中心的外科医生和护士的调查。

Perception of risk in massive transfusion as it relates to fetal outcomes: A survey of surgeons and nurses at one American trauma center.

机构信息

Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Center for Injury Science and Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

出版信息

Transfusion. 2021 Jul;61 Suppl 1:S159-S166. doi: 10.1111/trf.16492.

DOI:10.1111/trf.16492

PMID:34269430

Abstract

BACKGROUND

The use of blood products early in the resuscitation of bleeding trauma patients is widely accepted, but made difficult by limited supplies of D- red blood cell (RBC)-containing products. Use of D+ RBC-containing products would alleviate this issue, but could lead to alloimmunization. Risk associated with transfusing D+ RBC in emergency bleeding situations is being reconsidered. The level of concern surrounding emergency transfusion as it relates to future fetal harm was surveyed among surgeons and nurses.

METHODS

Faculty and staff in the Departments of Surgery and Nursing were surveyed on the risks of receiving an emergency RBC transfusion and the subsequent potential for fetal harm. Answers were grouped as likely to accept (likely/very likely) or refuse transfusion (unlikely/very unlikely). Participants were compared by sex, and women by child-bearing age, ([15-50 years] vs. [>50 years]).

RESULTS

Ninety surveys were initiated with 76 fully completed. Male (n = 39) and female (n = 37) respondents were comparable. Most female respondents (30/37, 81%) were of childbearing age. Overall, both males (38/39, 95%) and females (33/37, 89%; p = .19) were likely to accept a transfusion in an emergency. There was no difference in transfusion acceptance if the risk of fetal harm was presented as 1% (p = .73) or 0.1% (p = .51). Most females (34/37, 92%) were not opposed to transfusion even if there was an unspecified risk of future fetal harm.

CONCLUSION

Most of the surgeons and nurses who responded would accept a transfusion in an emergency situation even if it might lead to harming a future fetus.

摘要

背景

在出血创伤患者的复苏早期使用血液制品已被广泛接受，但由于 D-红细胞（RBC）含血制品的供应有限，这一做法变得困难。使用 D+ RBC 含血制品可以缓解这个问题，但可能导致同种免疫。在紧急出血情况下输注 D+ RBC 的风险正在重新考虑。外科医生和护士对与未来胎儿伤害相关的紧急输血风险进行了调查。

方法

对外科和护理部门的教职员工进行了接受紧急 RBC 输血的风险以及随后潜在胎儿伤害的调查。答案分为可能接受（可能/很可能）或拒绝输血（不太可能/很不可能）。按性别比较参与者，按生育年龄（[15-50 岁]与[>50 岁]）比较女性。

结果

共发放了 90 份调查，其中 76 份完整填写。男性（n=39）和女性（n=37）受访者相似。大多数女性受访者（37 名中的 30 名，81%）处于生育年龄。总体而言，男性（39 名中的 38 名，95%）和女性（37 名中的 33 名，89%；p=0.19）在紧急情况下都可能接受输血。如果胎儿伤害的风险为 1%（p=0.73）或 0.1%（p=0.51），则接受输血的意愿没有差异。即使存在未来胎儿伤害的未知风险，大多数女性（37 名中的 34 名，92%）也不反对输血。