Krishna Handattu M, Prasad Mukesh Kumar, Mitragotri Milon V, Bipin G I, Gupta Divya, Sharma Ridhima
Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India.
Department of Anaesthesiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
Indian J Anaesth. 2023 Jan;67(1):130-138. doi: 10.4103/ija.ija_1043_22. Epub 2023 Jan 21.
Transfusion of blood and blood products has many adverse effects and should be done only if patient benefits outweigh the associated risks. Current understanding of blood transfusion has improved dramatically, revolutionising the care of surgical, trauma, obstetric and critically ill patients. Most guidelines advise a restrictive approach for stable patients with non-haemorrhagic anaemia for red blood cell transfusion. The rationale for red blood cell transfusion has historically been to improve oxygen transport capacity and consumption-related parameters in anaemic patients. Current understanding casts serious doubts about the true potential of red blood cell transfusions to improve these factors. There may not be any benefit from blood transfusion beyond a haemoglobin threshold of 7 g/dL. In fact, liberal transfusion may be associated with higher complications. Guideline-based transfusion policy should be adopted for the administration of all blood products including fresh frozen plasma, platelet concentrates and cryoprecipitate etc. This should be integrated with clinical judgement.
输血及血液制品有许多不良反应，只有当患者的获益大于相关风险时才应进行输血。目前对输血的认识有了显著提高，给外科、创伤、产科和重症患者的护理带来了变革。大多数指南建议，对于非出血性贫血的稳定患者，采用限制性的红细胞输血方法。从历史上看，红细胞输血的基本原理是提高贫血患者的氧运输能力和与氧消耗相关的参数。目前的认识对红细胞输血改善这些因素的真正潜力提出了严重质疑。血红蛋白阈值超过7g/dL后，输血可能没有任何益处。事实上，自由输血可能会导致更高的并发症。对于包括新鲜冰冻血浆、浓缩血小板和冷沉淀等所有血液制品的输注，都应采用基于指南的输血政策。这应与临床判断相结合。
