在决定红细胞和血小板输血时所使用的阈值是如何符合指南的？

How do the threshold values used in the decision on red blood cell and platelet transfusions comply with the guidelines?

作者信息

Koc Begum Sirin, Tekkesin Funda, Yildirim Ulku Miray, Asarcikli Fikret, Kilic Suar Caki

机构信息

Department of Pediatric Hematology-Oncology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye.

Umraniye Training and Research Hospital, Blood Bank of Umraniye Training and Research Hospital, Istanbul, Turkiye.

出版信息

North Clin Istanb. 2022 Dec 9;9(6):595-601. doi: 10.14744/nci.2021.47640. eCollection 2022.

DOI:10.14744/nci.2021.47640

PMID:36685635

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9833389/

Abstract

OBJECTIVE

Blood transfusion is life-saving medical practice with significant risks. National and international guidelines have been established for indications related to blood use and threshold values for transfusions. In this study, we aimed to determine the erythrocyte and thrombocyte transfusion rates in surgical, internal, and emergency clinics in our hospital and to compare the threshold values before erythrocyte and platelet (PLT) transfusion among the clinics.

METHODS

Red blood cell (RBC) and PLT transfusions in our hospital between January 2019 and June 2019 were retrospectively analyzed. Clinics were divided into three groups: surgical clinics, internal clinics, and emergency clinic. Demographic characteristics, pre-transfusion hemoglobin (Hb), and PLT values of patients were recorded. Data were analyzed statistically.

RESULTS

During the 6-month study period, 5179 patients were transfused in 24,924 patients and the transfusion rate was 21%. In this period, a total of 14,518 units of blood products including 8369 units RBC suspension and 1390 units PLT suspension were transfused. The mean age of the patient was 50.32±28.88 years and the female/male ratio was 1.11. The most RBC transfusions were performed in the general internal medicine service in internal clinics and gynecology in surgical clinics. The most PLT transfusions were performed in the general medicine service in internal clinics and pediatric cardiovascular surgery in surgical clinics. ES transfusions were performed in the emergency medicine clinic with the lowest mean Hb value (Hb: 8.07±1.84 g/dl) and in the surgical clinics with the highest mean Hb value (Hb: 9.29±1.46 g/dl). TS transfusions were performed in internal clinics with the lowest mean PLT value (PLT: 44030±44075/mm), while the highest mean PLT value (PLT: 97140±75782/mm) was performed in surgical clinics.

CONCLUSION

It was observed that threshold values in particular for PLT transfusions in our hospital were above the guideline recommendations. Our results suggest that the knowledge level of physicians about transfusion limits and practices should be increased.

摘要

目的

输血是一种具有重大风险的挽救生命的医疗行为。国内外已针对用血指征和输血阈值制定了相关指南。在本研究中，我们旨在确定我院外科、内科和急诊科的红细胞及血小板输注率，并比较各科室红细胞和血小板（PLT）输血前的阈值。

方法

对我院2019年1月至2019年6月期间的红细胞（RBC）和PLT输血情况进行回顾性分析。科室分为三组：外科科室、内科科室和急诊科。记录患者的人口统计学特征、输血前血红蛋白（Hb）和PLT值。对数据进行统计学分析。

结果

在为期6个月的研究期间，24924例患者中有5179例接受了输血，输血率为21%。在此期间，共输注了14518单位血液制品，其中包括8369单位RBC悬液和1390单位PLT悬液。患者的平均年龄为50.32±28.88岁，女性/男性比例为1.11。内科的普通内科服务和外科的妇科进行的RBC输血最多。内科的普通内科服务和外科的小儿心血管外科进行的PLT输血最多。急诊科进行ES输血时患者的平均Hb值最低（Hb：8.07±1.84 g/dl），而外科进行ES输血时患者的平均Hb值最高（Hb：9.29±1.46 g/dl）。内科进行TS输血时患者的平均PLT值最低（PLT：44030±44075/mm），而外科进行TS输血时患者的平均PLT值最高（PLT：97140±75782/mm）。