The ongoing variability in blood transfusion practices in cardiac surgery
The ongoing variability in blood transfusion practices in cardiac surgery
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DOI：
10.1111/j.1537-2995.2008.01666.x
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发表时间：
2008-07-01
期刊：
影响因子：
2.9
通讯作者：
Mangano, Dennis T.
中科院分区：
文献类型：
--
作者：
Snyder-Ramos, Stephanie A.;Moehnle, Patrick;Mangano, Dennis T.
背景技术背景：尽管在过去的二十年里，血液利用一直受到相当大的审查，特别是在手术中，但比较各国围手术期输血实践的研究很少，国际标准的演变仍然未知。因此，本评价的目的是比较围手术期输血的血液成分在心脏手术中的多个中心在不同的countries.Study设计和方法：输血的做法进行了前瞻性研究，在16个国家的70个中心。对围手术期缺血流行病学II（EPI II）研究的多中心研究中随机选择的5065例心脏手术患者进行了评价。红细胞（RBC），新鲜冷冻血浆（FFP），血小板（PLT）的利用率进行了评估，每天，手术前，手术中，手术后，直到出院。结果：在16个国家，术中红细胞输注从9%到100%不等，术后25%到87%（输血患者的百分比）。同样，FFP的输注频率在术中为0 - 98%，术后为3 - 95%，PLT的输注频率分别为0 - 51%和0 - 39%。此外，不仅有显着的差异，在输血率中心之间在不同的国家，但也在机构间比较多个中心内nations.CONCLUSION：在心脏手术患者，显着的变异性输血实践存在中心之间在不同的国家，并建议在围手术期的做法模式，以及可能的不适当的使用差异。国际标准化的围手术期实践模式以及输血制度似乎是必要的。
BACKGROUND: Although blood utilization has been under considerable scrutiny for the past two decades, particularly for surgery, studies comparing perioperative blood transfusion practices between countries are rare, and the evolution of international standards remains unknown. Therefore, the objective of this evaluation was to compare the perioperative transfusion of blood components in cardiac surgery in multiple centers in different countries.STUDY DESIGN AND METHODS: Transfusion practice was investigated prospectively in 70 centers among 16 countries. A total of 5065 randomly selected cardiac surgery patients of the Multicenter Study of Perioperative Ischemia Epidemiology II (EPI II) Study were evaluated. Utilization of red blood cells (RBCs), fresh-frozen plasma (FFP), and platelets (PLTs) was assessed daily, before, during, and after surgery until hospital discharge.RESULTS: Intraoperative RBC transfusion varied from 9 to 100 percent among the 16 countries, and 25 to 87 percent postoperatively (percentage of transfused patients). Similarly, frequency of transfusion of FFP varied from 0 to 98 percent intraoperatively and 3 to 95 percent postoperatively, and PLT transfusion from 0 to 51 and 0 to 39 percent, respectively. Moreover, there were not only marked differences in transfusion rates between centers in different countries but also in inter-institutional comparison of multiple centers within countries.CONCLUSION: In cardiac surgical patients, marked variability in transfusion practice exists between centers in various countries and suggests differences in perioperative practice patterns as well as possible inappropriate use. International standardization of perioperative practice patterns as well as transfusion regimes appears necessary.