Rosario M D, Rumsey E W, Arakaki G, Tanoue R E, McDanal J, McNamara J J
J Trauma. 1978 Jul;18(7):498-506. doi: 10.1097/00005373-197807000-00004.
The report presents three studies of post-traumatic pulmonary insufficiency (PTPI). In the first no significant pulmonary hemodynamic or ventilatory changes in severely shocked baboons resuscitated with shed fresh blood or stored blood were observed over 48 or 84 hours. Second, a post-mortem study of patients receving more than 5 units of blood within 24 hours of death showed sme microemboli in the lungs in about two thirds. Patients with multiple microthrombi had received an average of 20.6 units of blood; patients with some or no microemboli 15.5 and 6.3, respectively. Third in a review of the respiratory complications of 153 multiple-trauma patients, it was shown that the formerly severe problems with PTPI were now well managed clinically, that persistent respiratory failure was now occurring much later after injury, and occurred almost exclusively in patients with sepsis. Relation of the above data to previous reports in the literature led to the conclusion that the clinical significance of microaggregates in stored blood, if any, is low, and that ultrafiltration to remove microemboli only makes sense if it does not impede the rate of blood infusion and does not increase cost.
该报告展示了三项关于创伤后肺功能不全（PTPI）的研究。第一项研究中，在48小时或84小时内，未观察到用新鲜 shed 血液或储存血液复苏的严重休克狒狒出现明显的肺血流动力学或通气变化。第二项研究，对在死亡24小时内接受超过5单位血液的患者进行的尸检显示，约三分之二的患者肺部有一些微栓子。有多个微血栓的患者平均接受了20.6单位血液；有一些或没有微栓子的患者分别接受了15.5单位和6.3单位血液。第三项研究，在对153例多发伤患者的呼吸并发症进行回顾时发现，以前严重的PTPI问题现在在临床上得到了很好的处理，持续性呼吸衰竭现在在受伤后出现的时间要晚得多，并且几乎只发生在脓毒症患者中。上述数据与文献中先前报告的关系得出结论，储存血液中微聚集体的临床意义（如果有）很低，并且只有在不阻碍输血速度且不增加成本的情况下，通过超滤去除微栓子才有意义。 （注：原文中“shed fresh blood”表述不太准确，可能是“shed blood”即“失血” ，这里暂按原文翻译）
