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非体外循环心脏手术患者的血液制品使用情况

Blood Products Utilization Status in Off-Pump Cardiac Surgery Patients.

作者信息

Chegini Azita, Alaei Mastaneh, Jahangiryan Afsaneh, Zadsar Maryam

机构信息

Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.

出版信息

Int J Hematol Oncol Stem Cell Res. 2023 Jul 1;17(3):200-209. doi: 10.18502/ijhoscr.v17i3.13310.

Abstract

Transfusion support has an essential role in coronary artery bypass graft (CABG). The time-honored gold standard for CABG is the on-pump procedure (ONCAB); however, off-pump coronary artery bypass (OPCAB) is also a safe, cost-benefit procedure with fewer blood transfusion requirements. This study was performed to evaluate transfusion patterns in OPCAB due to the diversity of transfusion practices. This retrospective study was performed to determine the transfusion rate and triggers in OPCAB patients. Medical files of all patients undergoing OPCAB surgery at Sanandaj Tohid Hospital in 2014 were reviewed. Patients' demographics data, preoperative laboratory tests (PT, aPTT, Hb, Hct, Platelet count), underlying medical conditions, and their possible relation to further transfusions and the ward department in which the transfusion had taken place were extracted. SPSS 16 Chicago software, T-student Test, One Way Anova, and χ2 exam were applied for data analysis. P values ≤0.05was considered significant. Among 91 elective OPCAB patients: 28(30.8%) women and 63(69.2%) men with mean age of 64.80±9.02 years, 63(69.23%) received a blood product. Mean utilization of PRBC, FFP, Platelet, and Cryoprecipitate were 2.17±2.044, 2.46±2.86, 2.86±3.80 and 0.40±2.10 units, respectively. ICU revealed the highest consumption rate for all products.  Female sex (p<0.001), Hypertension (P=0.002), and low hemoglobin(P=0.004) were noted as predictive factors for transfusion.  This study concluded that the transfusion rate in OPCAB is still very high in Iran (regarding a study in a countryside hospital) and that the highest utilization rate is seen in the ICU.

摘要

输血支持在冠状动脉旁路移植术(CABG)中起着至关重要的作用。CABG历史悠久的金标准是体外循环手术(ONCAB);然而,非体外循环冠状动脉旁路移植术(OPCAB)也是一种安全、具有成本效益且输血需求较少的手术。由于输血实践的多样性,本研究旨在评估OPCAB中的输血模式。本回顾性研究旨在确定OPCAB患者的输血率和触发因素。回顾了2014年在萨南达吉托希德医院接受OPCAB手术的所有患者的病历。提取了患者的人口统计学数据、术前实验室检查(PT、活化部分凝血活酶时间、血红蛋白、血细胞比容、血小板计数)、基础疾病及其与进一步输血的可能关系以及输血发生的病房科室。应用SPSS 16芝加哥软件、t检验、单因素方差分析和χ²检验进行数据分析。P值≤0.05被认为具有统计学意义。在91例择期OPCAB患者中:28例(30.8%)为女性,63例(69.2%)为男性,平均年龄为64.80±9.02岁,63例(69.23%)接受了血液制品。红细胞悬液、新鲜冰冻血浆、血小板和冷沉淀的平均使用量分别为2.17±2.044、2.46±2.86、2.86±3.80和0.40±2.10单位。重症监护病房(ICU)显示所有产品的消耗率最高。女性(p<0.001)、高血压(P=0.002)和低血红蛋白(P=0.004)被视为输血的预测因素。本研究得出结论,在伊朗(关于一家乡村医院的研究),OPCAB中的输血率仍然很高,且在ICU中利用率最高。

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