Indications for blood and blood product transfusion.
Indications for blood and blood product transfusion.
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DOI：
10.4103/0019-5049.144648
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发表时间：
2014-09
影响因子：
2.9
通讯作者：
Yaddanapudi L
中科院分区：
文献类型：
--
作者：
Yaddanapudi S;Yaddanapudi L
输血产品带有某些固有的风险，因此只有在改善患者预后的情况下才应进行输血。对文献进行回顾，以找出输血的适应症和对患者发病率和死亡率的影响。有高质量的证据表明，与自由输血相比，限制性输血以7-8g/dl的血红蛋白或出现贫血症状为触发因素是安全的，而且与增加死亡率无关。因此，在外科和危重病人中强烈建议采用限制性策略。有适度的证据表明，在接受大量输血的患者中使用血浆和血小板输注。没有足够的证据支持在任何其他临床环境中使用血浆、血小板和冷沉淀物。回顾研究表明，高血浆和高血小板与红细胞比例为1：1：1可提高存活率，但这一点尚未在随机试验中得到证实。
Transfusion of blood products carries certain inherent risks and hence it should be undertaken only if it improves patient outcome. A review of the literature was carried out to find the indications and effects of transfusion on morbidity and mortality of patients. There is high-quality evidence showing that restrictive blood transfusion with a transfusion trigger of haemoglobin of 7-8 g/dl or the presence of symptoms of anaemia is safe and not associated with increased mortality compared with liberal transfusion. Thus, restrictive strategy is strongly recommended in surgical and critically ill-patients. There is moderate evidence for the use of plasma and platelet transfusion in patients receiving massive blood transfusion. There is not enough evidence to support the use of plasma, platelets and cryoprecipitate in any other clinical setting. Retrospective studies show improved survival after high plasma and platelet to red blood cell ratio of 1:1:1, but this has not been confirmed in randomised trials.