Schäfer Henry, Edel Jan, Martinez Carlos, Wallenhorst Christopher, Hellstern Alfred
Pneumologie, Kardiologie und Beatmungsmedizin, Gastroenterologie, Bürgerhospital Frankfurt, Frankfurt, Deutschland.
Frankfurt, Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt am Main, Deutschland.
Pneumologie. 2025 Feb;79(2):123-133. doi: 10.1055/a-2368-3815. Epub 2024 Sep 17.
Patients undergoing long-term ventilation often show anemia. The aim of the study was to investigate the duration and success of weaning from mechanical ventilation in patients with RBC transfusion.
A retrospective analysis of patient data from a weaning unit was performed. Transfused and non-transfused patients were matched using a propensity score. Of the 249 patients in the database, 31 transfused and the same number of non-transfused cases with similar disease severity as measured by the Simplified Acute Physiology Score (SAPS) could be analyzed. Additional sensitivity analyses were performed.
In the group of transfused patients, the difference in weaning duration was longer than in non-transfused patients (1.35 days and 3.26 days, respectively). Weaning success also varied. The risk of weaning failure was twice as high in the group of transfused patients. The groups also differed in terms of mortality, 25.8% of the transfused patients died, while in the non-transfused patients the mortality rate was 6.5%. The risk of death was increased in patients who received RBC transfusion. The differences were not statistically significant.
A high proportion of patients with prolonged mechanical ventilation have anemia. RBC transfusion does not improve their prognosis. The need for transfusion is associated with higher mortality and longer duration of weaning in this population. The indication for RBC transfusion should therefore be restrictive.
长期接受通气治疗的患者常出现贫血。本研究旨在调查接受红细胞输注的患者脱机的持续时间和成功率。
对一个脱机组的患者数据进行回顾性分析。使用倾向评分对输注和未输注患者进行匹配。在数据库中的249例患者中，可分析31例输注患者和相同数量的未输注患者，这些患者的疾病严重程度通过简化急性生理学评分（SAPS）来衡量，且病情相似。还进行了额外的敏感性分析。
在输注患者组中，脱机持续时间的差异比未输注患者组更长（分别为1.35天和3.26天）。脱机成功率也有所不同。输注患者组脱机失败的风险是未输注患者组的两倍。两组在死亡率方面也存在差异，25.8%的输注患者死亡，而未输注患者的死亡率为6.5%。接受红细胞输注的患者死亡风险增加。这些差异无统计学意义。
长时间机械通气的患者中很大一部分存在贫血。红细胞输注并不能改善他们的预后。在这一人群中，输血需求与更高的死亡率和更长的脱机持续时间相关。因此，红细胞输注的指征应严格限制。
