Acute lung injury after blood transfusion in mechanically ventilated patients
Acute lung injury after blood transfusion in mechanically ventilated patients
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DOI：
10.1111/j.1537-2995.2004.04053.x
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发表时间：
2004-10-01
期刊：
影响因子：
2.9
通讯作者：
Moore, SB
中科院分区：
文献类型：
--
作者：
Gajic, O;Rana, R;Moore, SB
背景技术背景：自由输血策略增加了急性肺损伤（ALI）的风险，但具体的输血相关因素尚未得到表征。我们测试的假设，储存年龄和特定类型的血液制品与机械通气patients.Study设计和方法：从机械通气患者的数据库中，我们确定了那些谁收到血液制品在重症监护的第一个48小时的风险增加。我们提取了关于潜在的ALI风险因素以及所用血液制品的类型、数量和储存期的信息。结果进行了评估，通过一个独立的，盲目审查胸片和临床findings.Results：181例输血在第一个48小时的机械通气，60（33%）发展急性肺损伤。发生和未发生ALI的患者之间红细胞储存的平均持续时间没有差异（中位数，18.5 vs. 17.5天; p = 0.22）。在多变量logistic回归分析中，与ALI发生相关的重要危险因素是血小板减少症（比值比，5.9; p = 0.004）和新鲜冷冻血浆输注（比值比，3.2; p = 0.023）。结论：血小板减少和新鲜冷冻血浆的输注，但不包括红细胞的储存年龄，与该机械通气患者队列中ALI的发生相关。
BACKGROUND: Liberal transfusion strategy increases the risk of acute lung injury (ALI), but specific transfusion-related factors have not been characterized. We tested the hypotheses that storage age and specific type of blood products are associated with increased risk of ALI in mechanically ventilated patients.STUDY DESIGN AND METHODS: From a database of mechanically ventilated patients, we identified those who received blood products during the first 48 hours of intensive care. We extracted information about underlying ALI risk factors as well as the type, amount, and shelf age of administered blood products. Outcome was assessed by an independent, blind review of chest radiographs and clinical findings.RESULTS: Of 181 patients transfused during the first 48 hours of mechanical ventilation, 60 (33%) developed ALI. There was no difference in average duration of red blood cells storage between patients who did and did not develop ALI (median, 18.5 vs. 17.5 days; p = 0.22). In a multivariable logistic regression analysis, important risk factors associated with the development of ALI were thrombocytopenia (odds ratio, 5.9; p = 0.004) and transfusion of fresh frozen plasma (odds ratio, 3.2; p = 0.023).CONCLUSION: Thrombocytopenia and transfusion of fresh frozen plasma, but not storage age of red blood cells, were associated with the development of ALI in this cohort of mechanically ventilated patients.