Risk factors and outcome of transfusion-related acute lung injury in the critically ill: A nested case-control study
Risk factors and outcome of transfusion-related acute lung injury in the critically ill: A nested case-control study
复制标题
DOI：
10.1097/ccm.0b013e3181cc4d4b
复制
发表时间：
2010-03-01
影响因子：
8.8
通讯作者：
Juffermans, Nicole P.
中科院分区：
文献类型：
--
作者：
Vlaar, Alexander P. J.;Binnekade, Jan M.;Juffermans, Nicole P.
目的：为了确定的发病率，危险因素，输血相关的急性肺损伤的危重病patients.Design队列的结果：在一项回顾性队列研究中，输血相关的急性肺损伤的患者被确定使用的共识标准急性肺损伤后6小时内输血。入选标准是重症监护室入院时间>48小时。发生输血相关急性肺损伤的患者与（根据年龄、性别和入院诊断）对输血对照受试者和其他来源的急性肺损伤患者进行研究。设置：三级转诊医院。患者：2004年11月1日至2007年10月1日入住重症监护室的所有首次入院患者。干预措施：无。测量和主要结果：在5208例住院患者中，2024例患者的住院时间>48小时，其中109例为疑似输血相关急性肺损伤病例。与输血对照受试者相比，输血相关急性肺损伤的危险因素是急诊心脏手术（比值比，17.6 [1.8-168.5]），恶性血液病（比值比，13.1 [2.7-63.8]），大量输血（比值比，4.5 [2.1-9.8]），脓毒症（比值比，2.5 [1.2-5.2]）、机械通气（比值比，3.0 [1.3-7.1]）和高急性生理学和慢性健康评估II评分（比值比，1.1 [1.0-1.1]; p
Objectives: To determine the incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of critically ill patients.Design: In a retrospective cohort study, patients with transfusion-related acute lung injury were identified using the consensus criteria of acute lung injury within 6 hrs after transfusion. Inclusion criterion was a length of intensive care unit admission >48 hrs. Patients developing transfusion-related acute lung injury were matched (on age, sex, and admission diagnosis) to transfused control subjects and patients developing acute lung injury from another origin.Setting: Tertiary referral hospital.Patients: All first-admitted patients from November 1, 2004, until October 1, 2007, to the intensive care unit.Interventions: None.Measurements and Main Results: Of 5208 admitted patients, 2024 patients had a length of stay >48 hrs, of whom 109 were suspected transfusion-related acute lung injury cases. Compared with transfused control subjects, risk factors for transfusion-related acute lung injury were emergency cardiac surgery (odds ratio, 17.6 [1.8-168.5]), hematologic malignancy (odds ratio, 13.1 [2.7-63.8]), massive transfusion (odds ratio, 4.5 [2.1-9.8]), sepsis (odds ratio, 2.5 [1.2-5.2]), mechanical ventilation (odds ratio, 3.0 [1.3-7.1], and high Acute Physiology and Chronic Health Evaluation II score (odds ratio, 1.1 [1.0-1.1]; p