Goodnough L T, Despotis G J, Hogue C W, Ferguson T B
Department of Pathology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Ann Thorac Surg. 1995 Aug;60(2):473-80. doi: 10.1016/0003-4975(95)98960-3.
Guidelines for transfusion practice have had limited impact in altering physician transfusion behavior in patients undergoing cardiac operations. This may be due to a lack of consensus on the relative risks and benefits of blood in these patients who are anemic, limited access to timely data that are necessary on which to base transfusion decisions, the recognition that empiric hemoglobin/hematocrit thresholds are limited clinical indicators of the need for blood, or a combination of these. We present an overview of current transfusion and blood conservation practices in this setting, along with possible approaches to guide the decision-making process by coupling the use of transfusion algorithms with point of care testing to use more physiologic indicators of the need for blood transfusion.
输血实践指南在改变心脏手术患者的医生输血行为方面影响有限。这可能是由于对于这些贫血患者输血的相对风险和益处缺乏共识、难以获得及时的必要数据以作为输血决策的依据、认识到经验性血红蛋白/血细胞比容阈值作为输血需求的临床指标存在局限性，或这些因素的综合作用。我们概述了这种情况下当前的输血和血液保护实践，以及通过将输血算法的使用与床旁检测相结合以使用更具生理学意义的输血需求指标来指导决策过程的可能方法。
