Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center.
Division of Critical Care Medicine, Department of Anesthesiology, The Ohio State University, Columbus, Ohio.
Clin Obstet Gynecol. 2023 Jun 1;66(2):408-414. doi: 10.1097/GRF.0000000000000766. Epub 2022 Nov 24.
Consideration for blood products replacement in postpartum hemorrhage should be given when blood loss exceeds 1.5 L or when an estimated 25% of blood has been lost. In cases of massive hemorrhage, standardized transfusion protocols have been shown to improve maternal morbidity and mortality. Most protocols recommend a balanced transfusion involving a 1:1:1 ratio of packed red blood cells, platelets, and fresh frozen plasma. Alternatives such as cryoprecipitate, fibrinogen concentrate, and prothrombin complex concentrates can be used in select clinical situations. Although transfusion of blood products can be lifesaving, it does have associated risks.
当出血量超过 1.5L 或估计失血达 25%时，应考虑产后出血时的血液制品替代。在大量出血的情况下，标准化输血方案已被证明可改善产妇的发病率和死亡率。大多数方案建议进行平衡输血，涉及红细胞、血小板和新鲜冷冻血浆的 1:1:1 比例。在某些临床情况下，可以使用冷沉淀、纤维蛋白原浓缩物和凝血酶原复合物浓缩物等替代物。尽管输血可以挽救生命，但确实存在相关风险。
