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Anesthesiology：新鲜冰冻血浆与晶体体外循环启动在小儿心脏手术中的比较：随机临床试验

2019-11-29 anesthGH “罂粟花”微信号

冰冻血浆心脏
关注

在先天性心脏手术中，用新鲜冰冻血浆（FFP）预充体外循环（CPB）以防止凝血异常。假设在出血和/或输血需要方面，晶体启动与FFP预充CPB不同。

背景与目的

在先天性心脏手术中，用新鲜冰冻血浆（FFP）预充体外循环（CPB）以防止凝血异常。假设在出血和/或输血需要方面，晶体启动与FFP预充CPB不同。

方  法

在这项平行双盲研究中，除了预先确定的用于所有患者的填充红细胞数量外，体重在7到15公斤之间的患者被随机分配到用15ml·kg-1晶体或15ml·kg-1 FFP启动的CPB中。输血的决定是临床上的，并以护理点试验为指导。主要终点包括胸导管追踪的术后出血、使用任何额外血液制品输血的患者人数、及术中和术后使用额外血液制品的总人数。术后时间为重症监护病房到达后6h。

结  果

对30例FFP组和29例血浆组患者进行了意向治疗分析。FFP组中的中位术后失血量为7.1mL·kg/1（5.1，9.4），晶体组的中位术后失血量为5.7mL·kg/1（3.8，8.5）（p=0.219）；差异（95%CI）：1.2（0.7至3.2）。在FFP和晶体组中，额外输血的患者比例分别为26.7%（8/30）和37.9%（11/29）（p=0.355；比值比[95%CI]，1.7[0.6至5.1]）。在FFP和晶体组中，除灌注外，输血外任何血液产品的中位数量分别为0（0，1）和0（0，2）（p=0.254；差异[95%CI]，0[0至0]）。没有研究相关的不良事件。

结  论

结果表明，在婴儿和儿童中，用晶体预充CPB并不会导致不同的术后出血风险，也不会导致异基因血制品需要输血的风险。

原始出处：

Dieu A， Rosal Martins M， Eeckhoudt S，et al. Fresh FrozenPlasma versus Crystalloid Priming of Cardiopulmonary Bypass Circuit in Pediatric Surgery： A Randomized Clinical Trial. Anesthesiology. 2019 Oct 23. doi：10.1097/ALN.0000000000003017.

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    2020-02-24 xiangyuzhou971

    #EST#

    0

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    2020-05-05 ms117281293605716

    #随机临床试验#

    0

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    2020-08-27 ms691033630344116

    #新鲜冰冻血浆#

    0

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    2020-04-27 ms8543593053280928

    #冰冻血浆#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2051477, encodeId=533720514e7f6, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Feb 24 02:55:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1661389, encodeId=2f7a166138900, content=<a href='/topic/show?id=5f119844112' target=_blank style='color:#2F92EE;'>#随机临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98441, encryptionId=5f119844112, topicName=随机临床试验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbb125274547, createdName=ms117281293605716, createdTime=Tue May 05 10:55:00 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756982, encodeId=14bf1e56982b4, content=<a href='/topic/show?id=1eae58e46cc' target=_blank style='color:#2F92EE;'>#新鲜冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58746, encryptionId=1eae58e46cc, topicName=新鲜冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df1f37283439, createdName=ms691033630344116, createdTime=Thu Aug 27 07:55:00 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037885, encodeId=e8a5203e88501, content=<a href='/topic/show?id=25693104e16' target=_blank style='color:#2F92EE;'>#冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31047, encryptionId=25693104e16, topicName=冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIW7uIr5ebYvJohUq0dkkVV05uF9jPpeyCrlcx904mUdMI9UKqpO3bt4GkgYBNdv485qT2NsVE27w/132, createdBy=023c2500122, createdName=ms8543593053280928, createdTime=Mon Apr 27 18:55:00 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344557, encodeId=cdd9134455ebc, content=<a href='/topic/show?id=896f26550c8' target=_blank style='color:#2F92EE;'>#体外循环#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26550, encryptionId=896f26550c8, topicName=体外循环)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588399, encodeId=9a1d1588399b5, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038898, encodeId=3bbf1038898b0, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Fri Nov 29 20:55:00 CST 2019, time=2019-11-29, status=1, ipAttribution=)]
    2019-12-01 12498ebem19暂无昵称

    #体外循环#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2051477, encodeId=533720514e7f6, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Feb 24 02:55:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1661389, encodeId=2f7a166138900, content=<a href='/topic/show?id=5f119844112' target=_blank style='color:#2F92EE;'>#随机临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98441, encryptionId=5f119844112, topicName=随机临床试验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbb125274547, createdName=ms117281293605716, createdTime=Tue May 05 10:55:00 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756982, encodeId=14bf1e56982b4, content=<a href='/topic/show?id=1eae58e46cc' target=_blank style='color:#2F92EE;'>#新鲜冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58746, encryptionId=1eae58e46cc, topicName=新鲜冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df1f37283439, createdName=ms691033630344116, createdTime=Thu Aug 27 07:55:00 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037885, encodeId=e8a5203e88501, content=<a href='/topic/show?id=25693104e16' target=_blank style='color:#2F92EE;'>#冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31047, encryptionId=25693104e16, topicName=冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIW7uIr5ebYvJohUq0dkkVV05uF9jPpeyCrlcx904mUdMI9UKqpO3bt4GkgYBNdv485qT2NsVE27w/132, createdBy=023c2500122, createdName=ms8543593053280928, createdTime=Mon Apr 27 18:55:00 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344557, encodeId=cdd9134455ebc, content=<a href='/topic/show?id=896f26550c8' target=_blank style='color:#2F92EE;'>#体外循环#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26550, encryptionId=896f26550c8, topicName=体外循环)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588399, encodeId=9a1d1588399b5, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038898, encodeId=3bbf1038898b0, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Fri Nov 29 20:55:00 CST 2019, time=2019-11-29, status=1, ipAttribution=)]
    2019-12-01 skhzy

    #ESI#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2051477, encodeId=533720514e7f6, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Feb 24 02:55:00 CST 2020, time=2020-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1661389, encodeId=2f7a166138900, content=<a href='/topic/show?id=5f119844112' target=_blank style='color:#2F92EE;'>#随机临床试验#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98441, encryptionId=5f119844112, topicName=随机临床试验)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbb125274547, createdName=ms117281293605716, createdTime=Tue May 05 10:55:00 CST 2020, time=2020-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756982, encodeId=14bf1e56982b4, content=<a href='/topic/show?id=1eae58e46cc' target=_blank style='color:#2F92EE;'>#新鲜冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58746, encryptionId=1eae58e46cc, topicName=新鲜冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=df1f37283439, createdName=ms691033630344116, createdTime=Thu Aug 27 07:55:00 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2037885, encodeId=e8a5203e88501, content=<a href='/topic/show?id=25693104e16' target=_blank style='color:#2F92EE;'>#冰冻血浆#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31047, encryptionId=25693104e16, topicName=冰冻血浆)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIW7uIr5ebYvJohUq0dkkVV05uF9jPpeyCrlcx904mUdMI9UKqpO3bt4GkgYBNdv485qT2NsVE27w/132, createdBy=023c2500122, createdName=ms8543593053280928, createdTime=Mon Apr 27 18:55:00 CST 2020, time=2020-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344557, encodeId=cdd9134455ebc, content=<a href='/topic/show?id=896f26550c8' target=_blank style='color:#2F92EE;'>#体外循环#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26550, encryptionId=896f26550c8, topicName=体外循环)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588399, encodeId=9a1d1588399b5, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Sun Dec 01 08:55:00 CST 2019, time=2019-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038898, encodeId=3bbf1038898b0, content=高质量研究，读起来真爽，谢谢梅斯, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=肿瘤克星, createdTime=Fri Nov 29 20:55:00 CST 2019, time=2019-11-29, status=1, ipAttribution=)]
    2019-11-29 肿瘤克星

    高质量研究，读起来真爽，谢谢梅斯

    0