Friedlander M H, Simon R, Machiedo G W
Department of Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Shock. 1998 Feb;9(2):84-8. doi: 10.1097/00024382-199802000-00002.
RBC deformability (RBCD) is decreased in critically ill patients. This is thought to impede the passage of the RBC through the microcirculation. The cell transit analyzer (CTA) provides an evaluation of RBCD. RBCD was examined in 16 patients admitted to the surgical intensive care unit. CTA analysis was conducted within 24 h of admission to the surgical intensive care unit or as soon as possible thereafter, and then repeated every 72 h. Counts per second (C/s) was the parameter used as an index of RBCD. Patients were classified as Septic/SIRS or nonseptic at the time of each blood collection by standard clinical criteria. There were 34 total specimens, 22 septic/SIRS and 12 nonseptic. The C/s for the SIRS samples (41.7 +/- 3.4 was significantly (p < .05) lower than that of the non-SIRS samples (54.3 +/- 5.3). Seventeen of the Septic/SIRS samples were obtained following blood transfusion. Pearson's test calculated for the C/s and the total number of packed RBC transfusions showed a positive correlation (r = .594) that was statistically significant (p < .02). CTA was also performed on 10 U of banked packed RBC in vitro. Deformability was maintained at a constant level until the very end of the storage period, at which time there was a statistically significant decrease in C/s (p < .0001). These data suggest that packed RBC transfusion is associated with a significant improvement in the abnormally low RBCD seen in critically ill patients. This may be due to replacement of previously rigidified cells by cells with a more normal RBCD.
危重症患者的红细胞变形性（RBCD）降低。这被认为会阻碍红细胞通过微循环。细胞转运分析仪（CTA）可对RBCD进行评估。对16名入住外科重症监护病房的患者进行了RBCD检测。在入住外科重症监护病房后24小时内或之后尽快进行CTA分析，然后每72小时重复一次。每秒计数（C/s）作为RBCD的指标参数。每次采血时，根据标准临床标准将患者分为脓毒症/全身炎症反应综合征（SIRS）组或非脓毒症组。共采集了34份标本，其中22份为脓毒症/SIRS组，12份为非脓毒症组。SIRS样本的C/s（41.7±3.4）显著低于非SIRS样本（54.3±5.3）（p<0.05）。17份脓毒症/SIRS样本是在输血后采集的。对C/s与红细胞悬液输注总量进行Pearson检验，结果显示呈正相关（r=0.594），具有统计学意义（p<0.02）。还对10单位库存红细胞悬液进行了体外CTA检测。在储存期结束前，变形性一直维持在恒定水平，此时C/s出现统计学显著下降（p<0.0001）。这些数据表明，输注红细胞悬液与危重症患者异常降低的RBCD显著改善有关。这可能是由于用RBCD更正常的细胞替代了之前僵化的细胞。
