Predeposited autologous blood for elective surgery. A national multicenter study.
Predeposited autologous blood for elective surgery. A national multicenter study.
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预存自体血用于择期手术。
DOI：
10.1056/nejm198702263160906
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Goodnough,LT
中科院分区：
文献类型：
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作者：
Toy,PT;Strauss,RG;Stehling,LC;Sears,R;Price,TH;Rossi,EC;Collins,ML;Crowley,JP;Eisenstaedt,RS;Goodnough,LT
为了确定在何种程度上已提前捐赠（“预存”）自体血液用于择期手术的患者，并评估是否提前捐赠减少使用同源血液和对血液供应的需求，我们研究了4996例择期手术患者在18个三级医院。为1287名患者（26%）订购了交叉配血，其中590名（46%）被认为有资格预存血液。只有5%（32）符合条件的患者实际上预先存血，这表明预先献血并没有被广泛使用。在预存者中，只有13%（32人中的4人）随后接受了同源血液，而在未预存者中，这一比例为36%（558人中的199人）（P<0.01）。在199名没有预存但需要输血的患者中，我们估计预存可以避免多达68%的同种输血。如果所有符合条件的患者都有预存的自体血，他们可以提供多达72%的自己输注的红细胞。在所有红细胞输血中，多达10%的血液可能是由接受择期手术的患者预先捐献并输入的。更多地使用预献血不仅可以通过减少对同种输血的需求来减少对血液供应的需求，而且还可能降低肝炎和其他输血相关疾病的风险。（N Engl J Med 1987; 316：517-20.）
To determine the extent to which autologous blood that has been donated in advance ("predeposited") is used in patients undergoing elective surgery and to assess whether predonation decreases the use of homologous blood and the demand on the blood supply, we studied 4996 patients undergoing elective surgery at 18 tertiary care hospitals. Cross-matched blood was ordered for 1287 patients (26 percent), and of these, 590 (46 percent) were considered eligible for predepositing blood. Only 5 percent (32) of the eligible patients actually predeposited blood, indicating that predonation is not widely used. Of those who predeposited, only 13 percent (4 of 32) subsequently received homologous blood, as compared with 36 percent (199 of 558) of those who did not predeposit (P<0.01). Among the 199 patients who did not predeposit but required transfusion, we estimate that predonation could have avoided homologous transfusion in as many as 68 percent. If all eligible patients had predeposited autologous blood, they could have supplied as much as 72 percent of their own transfused red cells. The blood for as much as 10 percent of all red-cell transfusions could have been predonated by and transfused into the patients undergoing elective surgery. Greater use of predonation would not only reduce the demand on the blood supply by decreasing the need for homologous transfusion, but would probably also reduce the risk of hepatitis and other transfusion-associated illnesses. (N Engl J Med 1987; 316:517–20.)