Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.
Clotting functional stability of withdrawing blood in storage for acute normovolemic hemodilution: a pilot study.
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急性等容血液稀释时抽取血液储存的凝血功能稳定性：一项初步研究。
DOI：
10.1007/s00540-020-02856-x
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发表时间：
2021-03
影响因子：
2.8
通讯作者：
Hirota K
中科院分区：
文献类型：
--
作者：
Kinoshita H;Saito J;Nakai K;Noguchi S;Takekawa D;Tamai Y;Kitayama M;Hirota K
本研究旨在探讨急性等容血液稀释（ANH）患者抽血时凝血功能的时程变化。2018年8月至2019年1月，12例入组患者接受了ANH。将血液抽取到血液收集包中，并在室温下以60-80 rpm振荡24 h。在抽血后即刻（对照）和抽血后4、8、12和24小时使用旋转血栓弹性测定法（ROTEM™）评价凝块形成。并与对照组、组织因子体外激活试验（EXTEM）、鞣花酸内在激活试验（INTEM）和纤维蛋白基组织因子体外激活试验（FIBTEM）的各项指标进行比较。FIB TEM的最大凝块硬度（MCF）无显著变化。EXTEM组MCF随时间延长而明显降低，但均在正常范围内。EXTEM的MCF的最大百分比变化为12.4% [95%置信区间（CI）：9.0-15.8%]。从抽血后8小时开始，EXTEM和FIBTEM之间的最大凝块弹性（MCE）差异（MCEEXTEM-MCEFIBTEM）显著降低。采血后24 h，MCEEXTEM−MCEFIBTEM的最大百分比变化为30.2%（95% CI：17.6-42.9%）。尽管MCE以时间依赖性方式显著降低，但FIBTEM和EXTEM的MCF在储存24 h内正常。ANH患者的血液采血后在室温下至少保存8 h可用于止血。需要进一步的研究来阐明延迟输注ANH血液对患者止血的临床影响。本文的在线版本（10.1007/s 00540 -020-02856-x）包含补充材料，可供授权用户使用。
This study was conducted to time-course changes of clotting function of withdrawing blood for acute normovolemic hemodilution (ANH). Twelve enrolled patients who underwent ANH from August, 2018 to January, 2019. Blood was withdrawn into blood collection pack and shaken at 60–80 rpm for 24 h in room temperature. Clot formation was evaluated using rotational thromboelastometry (ROTEM™) just after blood withdrawal (control) and 4, 8, 12 and 24 h after blood withdrawal. We compared with the control value and each value of extrinsically-activated test with tissue factor (EXTEM), intrinsically-activated test using ellagic acid (INTEM) and fibrin-based extrinsically activated test with tissue factor (FIBTEM). Maximum clot firmness (MCF) of FIBTEM did not change significantly. MCF of EXTEM was significantly decreased time-dependent manner but all MCF of EXTEM were within a normal range. Maximum percent change in MCF of EXTEM was 12.4% [95% confidence interval (CI): 9.0–15.8%]. The difference in the maximum clot elasticity (MCE) between EXTEM and FIBTEM (MCEEXTEM−MCEFIBTEM) was significantly decrease from 8 h after blood withdrawal. Maximum percent change in MCEEXTEM−MCEFIBTEM was 30.2% (95% CI:17.6–42.9%) at 24 h after blood withdrawal. Even though the MCE significantly decreased in a time-dependent manner, MCF of FIBTEM and EXTEM was normal up to 24 h storage. The blood of ANH can use for the purpose of hemostasis at least 8 h stored at room temperature after blood withdrawal. Future studies are needed to elucidate the clinical impact on the patient after delayed transfusion of ANH blood with regard to patient’s hemostasis. The online version of this article (10.1007/s00540-020-02856-x) contains supplementary material, which is available to authorized users.
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