Allogeneic blood transfusions: benefit, risks and clinical indications in countries with a low or high human development index
Allogeneic blood transfusions: benefit, risks and clinical indications in countries with a low or high human development index
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DOI：
10.1093/bmb/ldh023
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发表时间：
2004-01-01
影响因子：
6.7
通讯作者：
Spahn, DR
中科院分区：
文献类型：
--
作者：
Marcucci, C;Madjdpour, C;Spahn, DR
与同种异体红细胞（RBC）输注相关的风险在人类发育指数（HDI）低和高的国家之间存在显著差异。在人类发展指数较低的国家，感染（艾滋病毒、乙型肝炎病毒、丙型肝炎病毒和疟疾）的风险较高。相反，在人类发展指数高的国家，免疫反应（溶血性输血反应、同种免疫和免疫抑制）占主导地位。因此，在低人类发展指数国家与红细胞输血相关的总体风险比在高人类发展指数国家更显著。鉴于这些风险，红细胞输注的有限疗效和高昂的费用，应谨慎和合理地使用该程序。因此，适应当地情况的红细胞输注方案至关重要。此类方案应区分生理性和基于血红蛋白的输血触发因素。在HDI高、相对心动过速和低血压的国家，尽管血容量正常，但ST段变化提示心肌缺血和Hb水平> 80岁，以及冠状动脉或脑血管疾病。在HDI低的国家，循环衰竭或心肌缺血的临床体征和Hb水平
The risks associated with allogeneic red blood cell (RBC) transfusions differ significantly between countries with low and high human development indexes (HDIs). In countries with a low HDI, the risk of infection (HIV, HBV, HCV and malaria) is elevated. In contrast, in countries with a high HDI, immunological reactions (haemolytic transfusion reactions, alloimmunization and immunosuppression) are predominant. Therefore the overall risk associated with RBC transfusions in low HDI countries is much more significant than that in high HDI countries. In view of these risks, the limited efficacy of RBC transfusion and its high costs, this procedure should be used sparingly and rationally. Therefore RBC transfusion protocols adapted to the local situation are essential. Such protocols should distinguish between physiological and haemoglobin-based transfusion triggers. In countries with a high HDI, relative tachycardia and hypotension, despite normovolaemia, ST-segment changes suggestive of myocardial ischaemia and an Hb level 80 years and those with coronary artery or cerebrovascular disease. In countries with a low HDI, clinical signs of circulatory failure or myocardial ischaemia and an Hb level