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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Transfusion of cell saver salvaged blood in neonates and infants undergoing open heart surgery significantly reduces RBC and coagulant product transfusions and donor exposures: Results of a prospective, randomized, clinical trial
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Transfusion of cell saver salvaged blood in neonates and infants undergoing open heart surgery significantly reduces RBC and coagulant product transfusions and donor exposures: Results of a prospective, randomized, clinical trial

机译：在接受心脏直视手术的新生儿和婴儿中保存细胞挽救性血液的输血显着减少了红细胞和凝血剂输血以及供体暴露：一项前瞻性，随机，临床试验的结果

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OBJECTIVE:: To evaluate whether transfusion of cell saver salvaged, stored at the bedside for up to 24 hrs, would decrease the number of postoperative allogeneic RBC transfusions and donor exposures, and possibly improve clinical outcomes. DESIGN:: Prospective, randomized, controlled, clinical trial. SETTING:: Pediatric cardiac intensive care unit. PATIENTS:: Infants weighing less than 20 kg (n = 106) presenting for cardiac surgery with cardiopulmonary bypass. INTERVENTIONS:: Subjects were randomized to a cell saver transfusion group where cell saver blood was available for transfusion up to 24 hrs after collection, or to a control group. Cell saver subjects received cell saver blood for volume replacement and/or RBC transfusions. Control subjects received crystalloid or albumin for volume replacement and RBCs for anemia. Blood product transfusions, donor exposures, and clinical outcomes were compared between groups. MEASUREMENTS AND MAIN RESULTS:: Children randomized to the cell saver group had significantly fewer RBC transfusions (cell saver: 0.19 ?? 0.44 vs. control: 0.75 ?? 1.2; p = 0.003) and coagulant product transfusions in the first 48 hrs post-op (cell saver: 0.09 ?? 0.45 vs. control: 0.62 ?? 1.4; p = 0.013), and significantly fewer donor exposures (cell saver: 0.60 ?? 1.4 vs. control: 2.3 ?? 4.8; p = 0.019). This difference persisted over the first week post-op, but did not reach statistical significance (cell saver: 0.64 ?? 1.24 vs. control: 1.1 ?? 1.4; p = 0.07). There were no significant clinical outcome differences. CONCLUSION:: Cell saver blood can be safely stored at the bedside for immediate transfusion for 24 hrs after collection. Administration of cell saver blood significantly reduces the number of RBC and coagulant product transfusions and donor exposures in the immediate postoperative period. Reduction of blood product transfusions has the potential to reduce transfusion-associated complications and decrease postoperative morbidity. Larger studies are needed to determine whether this transfusion strategy will improve clinical outcomes. ? 2013 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
机译：目的：评估是否可以挽救保存在床旁长达24小时的保存细胞的输血，将减少术后同种异体RBC输血和供体暴露的次数，并可能改善临床效果。设计：：前瞻性，随机，对照，临床试验。地点：小儿心脏重症监护室。患者：体重不足20千克（n = 106）的婴儿需进行心脏外科手术并进行体外循环。干预措施：：将受试者随机分配到一个保存细胞的输血组，在该组中可在收集后24小时内进行保存细胞的血液输注，或一个对照组。节省细胞的受试者接受了节省细胞的血液以进行体积置换和/或RBC输血。对照对象接受晶体或白蛋白置换以补充血容量，RBCs给予贫血。两组之间比较了输血，供体暴露和临床结局。测量和主要结果：随机分入细胞保护剂组的儿童输血后红细胞输注明显减少（细胞保护剂：0.19≤0.44，而对照组：0.75≤1.2; p = 0.003），并且在输注后的前48小时内输注凝结产物。 op（节省细胞：0.09≤0.45，相对于对照组：0.62≤1.4; p = 0.013），大大减少了供体暴露（节省细胞：0.60≤1.4与对照组：2.3≤4.8; p = 0.019）。这种差异在术后第一周一直存在，但是没有达到统计学显着性（细胞保护：0.64±1.24 vs.对照：1.1±1.4; p = 0.07）。没有明显的临床结果差异。结论：保存细胞的血液可以安全地储存在床边，以便在收集后24小时立即输血。节省细胞血液的施用在术后立即显着减少了RBC和凝结产物输血的数量以及供体暴露。减少输血产品有可能减少与输血有关的并发症并降低术后发病率。需要更大的研究来确定这种输血策略是否会改善临床结果。 ？ 2013年由重症医学会和世界儿科重症和重症监护学会联合会颁发。

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