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【输血纵览】低温创伤患者死亡率和血液制品用量的增加

分类:输血管理   来源:   日期:2019-04-01 17:12:09

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大约一半的创伤患者都经历过体温过低(体温低于36°C),这会导致凝血功能紊乱和不良的健康结果。由于低温和血液使用之间的关系尚未被调查,研究人员在实用随机最佳血小板和血浆比率(PROPPR)试验中与体温测量确定了590名创伤患者。590例患者中,399例(67.6%)在到达急救中心后6小时内体温过低。在最初24小时内输血的红细胞单位数平均为8.8个。然而,低温组患者在最初24小时内使用的红细胞单位(9.9)明显多于常温组(6.3)。此外,低温患者24小时(调整OR,2.7[95%CI,1.7-4.5];p<0.001)和30天(调整OR,1.8[95%CI,1.3-2.4];p<0.001)的死亡率均显着高于常温组(p<0.001)。需要进一步的研究,以更好地了解预防低温对死亡率、血液使用和器官保存的影响。

原文:About half of all trauma patients experience hypothermia (body temperature less than 36°C), which leads to coagulopathy and poor health outcomes. Since the association between hypothermia and blood use has not be investigated, researchers identified 590 trauma patients enrolled in the Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial with body temperature measurements. Of the 590 patients, 399 (67.6%) experienced hypothermia within 6 hours of arriving at the emergency care center. The mean number of RBC units transfused within the first 24 hours was 8.8. Patients with hypothermia, however, used significantly more RBC units (9.9) compared to patients in the normothermic group (6.3) within the first 24 hours. Furthermore, patients with hypothermia had significantly higher odds of dying compared to normothermic patients both at 24 hours (adjusted OR, 2.7 [95% CI, 1.7-4.5]; p<0.001) and 30 days (adjusted OR, 1.8 [95% CI, 1.3-2.4]; p<0.001). Further research is needed to better understand the effects of preventing hypothermia on mortality, blood use, and organ preservation.

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