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优化创伤性脑损伤中的红细胞输血策略:早期复苏与脑氧合的见解

Optimizing RBC Transfusion Strategies in Traumatic Brain Injury: Insights on Early Resuscitation and Cerebral Oxygenation.

作者信息

Ha Eun Jin

机构信息

Department of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Korean J Neurotrauma. 2024 Sep 11;20(3):137-145. doi: 10.13004/kjnt.2024.20.e26. eCollection 2024 Sep.

Abstract

Effective early resuscitation and maintenance of brain oxygenation are critical for improving the outcomes of patients with severe traumatic brain injury (TBI). Red blood cell (RBC) transfusion plays a vital role in this process. Although RBC transfusion can enhance cerebral oxygenation and stabilize hemodynamics, it also poses significant risks including transfusion-related lung injury and transfusion-associated circulatory overload, highlighting the importance of meticulous transfusion management. This review explores transfusion strategies during the early resuscitation phase and the management of anemia in patients with severe TBI, focusing on appropriate treatment targets, utilizing monitoring-based personalized approaches, and summarizing recent research and current insights.

摘要

有效的早期复苏和维持脑氧合对于改善重型创伤性脑损伤(TBI)患者的预后至关重要。红细胞(RBC)输注在这一过程中起着至关重要的作用。虽然RBC输注可以增强脑氧合并稳定血流动力学,但它也带来了重大风险,包括输血相关的肺损伤和输血相关的循环超负荷,这凸显了精心输血管理的重要性。本综述探讨了重型TBI患者早期复苏阶段的输血策略和贫血管理,重点关注适当的治疗目标,采用基于监测的个性化方法,并总结近期研究和当前见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fd6/11450338/84e098a21f22/kjn-20-137-g001.jpg

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