Higgins V L
Pall Biomedical Products Company, Division of Pall Corporation, East Hills, NY, USA.
Oncol Nurs Forum. 1996 May;23(4):659-67.
PURPOSE/OBJECTIVES: To review the various types of filters used for red blood cell and platelet transfusions and to explain the trend in the use of leukocyte removal filters, practical information about their use, considerations in the selection of a filtration method, and cost-effectiveness issues.
Published articles, books, and the author's experience.
Leukocyte removal filters are used to reduce complications associated with transfused white blood cells that are contained in units of red blood cells and platelets. These complications include nonhemolytic febrile transfusion reactions (NHFTRs), alloimmunization and refractoriness to platelet transfusion, transfusion-transmitted cytomegalovirus (CMV), and immunomodulation. Leukocyte removal filters may be used at the bedside, in a hospital blood bank, or in a blood collection center. Factors that affect the flow rate of these filters include the variations in the blood component, the equipment used, and filter priming. Studies on the cost-effectiveness of using leukocyte-reduced blood components demonstrate savings based on the reduction of NHFTRs, reduction in the number of blood components used, and the use of filtered blood components as the equivalent of CMV seronegative-screened products.
The use of leukocyte-reduced blood components significantly diminishes or prevents many of the adverse transfusion reactions associated with donor white blood cells. Leukocyte removal filters are cost-effective, and filters should be selected based on their ability to consistently achieve low leukocyte residual levels as well as their ease of use.
Physicians may order leukocyte-reduced blood components for specific patients, or the components may be used because of an established institutional transfusion policy. Nurses often participate in deciding on a filtration method, primarily based on ease of use. Understanding the considerations in selecting a filtration method will help nurses make appropriate decisions to ensure quality patient care.
目的/目标：回顾用于红细胞和血小板输注的各类过滤器，并解释白细胞去除过滤器的使用趋势、其使用的实用信息、过滤方法选择的考量因素以及成本效益问题。
已发表的文章、书籍以及作者的经验。
白细胞去除过滤器用于减少与红细胞和血小板单位中所含输注白细胞相关的并发症。这些并发症包括非溶血性发热性输血反应（NHFTRs）、同种免疫和血小板输注无效、输血传播的巨细胞病毒（CMV）以及免疫调节。白细胞去除过滤器可在床边、医院血库或采血中心使用。影响这些过滤器流速的因素包括血液成分的差异、使用的设备以及过滤器预充。关于使用白细胞减少的血液成分的成本效益研究表明，基于NHFTRs的减少、使用的血液成分数量的减少以及将过滤后的血液成分用作等同于CMV血清学阴性筛查产品，可实现节省。
使用白细胞减少的血液成分可显著减少或预防许多与供体白细胞相关的不良输血反应。白细胞去除过滤器具有成本效益，应根据其持续实现低白细胞残留水平的能力及其易用性来选择过滤器。
医生可能会为特定患者订购白细胞减少的血液成分，或者由于既定的机构输血政策而使用这些成分。护士通常主要基于易用性参与决定过滤方法。了解选择过滤方法的考量因素将有助于护士做出适当的决定，以确保为患者提供优质护理。
