Am J Emerg Med:成人创伤患者的大规模输血方案

2021-06-25 MedSci原创 MedSci原创

对于创伤中出现急性失血的患者,需要快速识别并采取行动以恢复患者的循环量。大量输血方案(MTPs)已成为创伤中心的标准,以便迅速向出血的患者提供血液制品。这篇文献综述介绍了目前的输血比例标准,以及对大量

对于创伤中出现急性失血的患者,需要快速识别并采取行动以恢复患者的循环量。大量输血方案(MTPs)已成为创伤中心的标准,以便迅速向出血的患者提供血液制品。这篇文献综述介绍了目前的输血比例标准,以及对大量输血时的辅助手段的见解,研究已发表于Am J Emerg Med。

研究人员在PubMED上搜索了2005年至2020年关于MTPs的文章,评估了文章的单一与多机构、损伤机制、MTP的类型、血液制品的使用时间、向创伤区输送血液制品的时间、院前治疗和辅助手段以及结果。

 

共有11项研究涉及了输血比例。7项研究探讨了血制品的时间。9项研究涉及MTP院前治疗和辅助治疗。在2015年之前,研究支持平衡输血比例,随后被PROPPR随机对照试验所证实。运送血制品的时间越短,结果越好。技术的新进展使我们能够测量不同的凝血模式,从而能够对出血的病人采取更加个性化的方法。

总之,目前的大量输血方案应使用1:1:1和1:1:2的比例的3种主要产品;血浆、血小板和红细胞。大量输血方案在降低死亡率方面是有效的。当病人到达创伤室时,如果有现成的血制品,可以看到更好的抢救工作,血液的更换越快,结果越好。

 

原始出处:

 

Evander Meneses, Dessy Boneva, et al., Massive transfusion protocol in adult trauma population. Am J Emerg Med. 2020 Dec;38(12):2661-2666. doi: 10.1016/j.ajem.2020.07.041.  

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    2022-04-25 ylz8403
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    2021-06-27 windight
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    2021-06-26 ms6000000079288216

    学习了

    0