Blajchman M A, Shepherd F A, Perrault R A
Can Med Assoc J. 1979 Jul 7;121(1):33-42.
The goal of modern transfusion therapy is to provide appropriate replacement therapy with blood components as opposed to whole blood for patients with specific hematologic deficiencies. A prerequisite of component therapy is, therefore, correct identification of the deficiency. Appropriate use of components avoids many of the hazards associated with the use of whole blood, and at the same time makes maximal use of this valuable resource. Blood components separated from whole blood soon after collection and appropriately stored can, in combination, provide all the factors present in fresh whole blood. Red cell concentrates prepared from multiple packs have a hematocrit of approximately 70%. They may be stored for up to 3 weeks at 4 degrees C and are recommended for most situations requiring red cell transfusions. Platelet concentrates, which can be stored for up to 72 hours at 22 degrees C, may be used for thrombocytopenic patients. Fresh frozen plasma, stored plasma, cryoprecipitated factor VIII, factor VIII concentrate and factor IX complex concentrate are available for the proper treatment of patients with hemorrhagic disorders due to coagulation factor deficiencies. Similarly, albumin and immune serum globulin are available for their oncotic and antibody properties respectively. Thus, the availability and appropriate use of the various blood products allows not only optimal transfusion therapy for each patient, but also fuller utilization of national blood resources.
现代输血治疗的目标是针对患有特定血液学缺陷的患者，提供合适的血液成分替代疗法，而非全血疗法。因此，成分疗法的一个先决条件是正确识别缺陷。合理使用血液成分可避免许多与使用全血相关的风险，同时能最大程度地利用这一宝贵资源。采集后不久从全血中分离并妥善储存的血液成分，综合起来可提供新鲜全血中存在的所有成分。由多袋血液制备的红细胞浓缩液的血细胞比容约为70%。它们可在4℃下储存长达3周，推荐用于大多数需要输注红细胞的情况。血小板浓缩液可在22℃下储存长达72小时，可用于血小板减少症患者。新鲜冰冻血浆、储存血浆、冷沉淀因子VIII、因子VIII浓缩液和因子IX复合浓缩液可用于正确治疗因凝血因子缺乏导致出血性疾病的患者。同样，白蛋白和免疫血清球蛋白分别因其胶体渗透压和抗体特性而可用。因此，各种血液制品的可得性和合理使用不仅能为每位患者提供最佳输血治疗，还能更充分地利用国家血液资源。
