Transfusion Medicine Reviews最新文献_第5页

The Association Between Anemia and Bleeding in Thrombocytopenic Patients with a Hematological Malignancy 血液学恶性肿瘤伴血小板减少患者贫血与出血的关系

IF 2.5 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-07-01 DOI: 10.1016/j.tmrv.2025.150911

Dimpy Modi, Nancy Heddle, Dongyoung Kim, Yang Liu, Donald Arnold

Introduction/Objective

Patients with hematological malignancies who are receiving chemotherapy have a heightened risk of bleeding because of the presence of both anemia and thrombocytopenia. The objective of this study was to determine the association between severe anemia, defined as hemoglobin (Hb) < 70 g/L in the three days before the first major bleeding event, and the risk of major bleeding in patients with hematological malignancy. A major bleed was defined as Grade 2 or higher on the World Health Organization (WHO) scale.

Design and Methods

We did a substudy of patients from the PREPAReS trial, a randomized trial comparing the efficacy of pathogen-inactivated platelets versus untreated platelet products in patients with hematological malignancy undergoing chemotherapy treatment. Daily hemoglobin levels, platelet counts, and WHO-graded bleeding assessments were collected during the trial. Cox regression analysis was used to assess the effect of anemia on risk of the first major bleed. Anemia was defined as a daily binary covariate of lowest Hb < 70 g/L or >/=70 g/L in the past three days. Cox regression models were adjusted for potential risk factors including sex, age, diagnosis (acute myeloid leukemia [AML] or non-AML), country, treatment stage, and study randomization arm. The substudy was approved by the research ethics board.

Results

565 patients were included from ten centres in three countries. 270 patients had AML (47.8%) and 182 patients were female (32.2%). In total, 321 patients (56.8%) developed a bleed of Grade 2 or higher. The first bleeding events were Grade 2 (n=309; 96.3%), Grade 3 (n=4; 1.2%) or Grade 4 (n= 8; 2.5%). A significant association between Hb < 70 and risk of bleeding was observed (Hazard ratio=1.71, p=0.009). Females had a higher risk of bleeding during the first seven days from randomization compared to males (HR=2.28, p< 0.001). Five (0.9%) females had vaginal-related bleeding. Difference in risk of major bleeding was observed between countries (p< 0.05).

Conclusions

Severe anemia was associated with major bleeding in patients with hematological malignancy undergoing chemotherapy. Maintaining a higher hemoglobin level for this patient group should be considered and evaluated in prospective trials.

简介/目的接受化疗的恶性血液病患者由于贫血和血小板减少症的存在，出血的风险增加。本研究的目的是确定重度贫血(定义为血红蛋白（Hb） <；70 g/L在第一次大出血事件发生前3天，与血液系统恶性肿瘤患者发生大出血的风险。世界卫生组织（WHO）将大出血定义为2级或以上。设计和方法我们对来自prepare试验的患者进行了一项亚研究，该试验是一项随机试验，比较了病原体灭活血小板与未经治疗的血小板产品在接受化疗的血液恶性肿瘤患者中的疗效。在试验期间收集每日血红蛋白水平、血小板计数和who分级出血评估。采用Cox回归分析评估贫血对首次大出血风险的影响。贫血被定义为每日最低Hb和lt的二元协变量；70 g/L或>；/=70 g/L。Cox回归模型调整了潜在危险因素，包括性别、年龄、诊断（急性髓性白血病[AML]或非AML）、国家、治疗阶段和研究随机分组。该子研究得到了研究伦理委员会的批准。结果共纳入来自3个国家10个中心的565例患者。AML 270例（47.8%），女性182例（32.2%）。共有321例患者（56.8%）发生2级或以上出血。首次出血事件为2级(n=309；96.3%)，三级(n=4；1.2%)或4级(n= 8；2.5%)。Hb和lt之间的显著关联；70例，观察出血风险（风险比=1.71,p=0.009）。与男性相比，女性在随机分组后的前7天出血的风险更高(HR=2.28, p<；0.001)。5名（0.9%）女性有阴道相关出血。大出血风险在不同国家之间存在差异(p<；0.05)。结论恶性血液病化疗患者严重贫血与大出血相关。在前瞻性试验中，应考虑并评估维持该患者组较高的血红蛋白水平。

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引用次数: 0

Intravenous Iron Therapy Versus Blood Transfusion for Iron Deficiency Anemia: A Systematic Review 静脉铁治疗与输血治疗缺铁性贫血：一项系统综述

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-06-04 DOI: 10.1016/j.tmrv.2025.150905

Martin Bedan , Christian Lottrup

This systematic review aimed to assess and compare the effect of blood transfusion and intravenous iron therapy on the hemoglobin levels based on clinical trials. To do this, a search was conducted 25^th of September 2024 by using PubMed, Cochrane, and Embase databases to identify studies comparing intravenous iron with blood transfusion in patients with iron deficiency anemia (<12 g/dL for women and <13 g/dL for men). The outcome selected was change in hemoglobin levels. The quality of the trials was assessed using Cochrane Risk of Bias Tool and Newcastle-Ottawa Quality Assessment Scale. We included 5 studies (three randomized controlled trials, 1 observational study and 1 retrospective study) comprising a total of 154,539 patients. Patient populations were heterogenous, encompassing surgical patients, patients undergoing hip fracture and pregnant women. Due to heterogeneity among the included studies, hemoglobin levels were reported at varying follow-up intervals. At 3 weeks follow-up or later after initial treatment, 3 studies reported significantly higher hemoglobin levels (ranging from 0.7 g/dL to 1.4 g/dL higher) in the intravenous iron group compared to the blood transfusion group. The remaining 2 studies found similar hemoglobin levels. Less than 3 weeks after initial treatment, 2 studies reported significantly higher hemoglobin levels in the blood transfusion group compared to the intravenous iron group. Our findings indicate that blood transfusion is more effective in achieving a rapid increase in hemoglobin levels shortly after therapy initiation, although this effect diminishes relatively swiftly. In contrast, intravenous iron seems to exert a more gradual increase in, but also longer lasting effect on, hemoglobin levels. However, our findings are limited by the small number of trials as well as questionable methodological quality of the included studies, resulting in a high risk of bias. Further investigation is warranted.

本系统综述旨在评估和比较输血和静脉铁治疗在临床试验基础上对血红蛋白水平的影响。为此，我们于2024年9月25日通过PubMed、Cochrane和Embase数据库进行了一项检索，以确定缺铁性贫血患者静脉注射铁与输血的比较研究（女性12g /dL，男性13g /dL）。选择的结果是血红蛋白水平的变化。使用Cochrane偏倚风险评估工具和Newcastle-Ottawa质量评估量表评估试验的质量。我们纳入了5项研究（3项随机对照试验、1项观察性研究和1项回顾性研究），共纳入154,539例患者。患者群体具有异质性，包括手术患者、髋部骨折患者和孕妇。由于纳入研究的异质性，血红蛋白水平在不同的随访时间间隔报告。在初始治疗后3周或更晚的随访中，有3项研究报告，与输血组相比，静脉注射铁组的血红蛋白水平明显更高（从0.7 g/dL到1.4 g/dL不等）。其余两项研究发现了相似的血红蛋白水平。初始治疗后不到3周，2项研究报告输血组的血红蛋白水平明显高于静脉注射铁组。我们的研究结果表明，输血在治疗开始后不久实现血红蛋白水平的快速增加更有效，尽管这种效果相对迅速地减弱。相比之下，静脉注射铁似乎对血红蛋白水平的影响更缓慢，但也更持久。然而，我们的发现受到试验数量少以及纳入研究的方法学质量问题的限制，导致高偏倚风险。有必要进一步调查。

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引用次数: 0

Combinations of Non-di(2-ethylhexyl) Phthalate Collection Sets, Storage Bags and Additive Solutions for Red Blood Cells 非二（2-乙基己基）邻苯二甲酸盐收集集，储存袋和红细胞添加剂溶液的组合

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-05-23 DOI: 10.1016/j.tmrv.2025.150904

Stefan F. van Wonderen , Christie Vermeulen , Johan Lagerberg , Alexander P.J. Vlaar , Thomas R.L. Klei

For decades, di(2-ethylhexyl) phthalate (DEHP) has been the primary plasticizer used to make polyvinyl chloride (PVC) blood bags flexible. DEHP leaches into the blood product, stabilizing red blood cell (RBC) membranes and preventing excessive hemolysis. Despite being classified as a substance of very high concern due to its potential endocrine-disrupting and carcinogenic effects, DEHP has continued to be used in red cell concentrate (RCC) storage bags, as alternatives have often led to reduced RCC quality during storage. However, under the European Medical Device Regulation the use of DEHP in medical devices is restricted to below 0.1% by weight per July 2030. As a result, the effect of several alternative plasticizers on RCC quality, such as di(2-ethylhexyl) terephthalate (DEHT), 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH), and N-butyryl-n-hexyl citrate (BTHC), have recently been investigated in combination with different storage solutions. Although previous studies using these new combinations showed variable results, these alternatives remain the most promising options, with current data demonstrating reduced leaching and lower toxicity compared to DEHP. This review highlights key publications on the transition from DEHP-PVC blood bag systems for RCC storage, demonstrating that several non-DEHP alternatives are viable replacement options, particularly when combined with next-generation storage solutions. Future studies are required to assess the frequency of adverse events, the occurrence of handling issues such as leakage, and to evaluate practical performance and clinical efficacy through post-transfusion recovery and increment studies.

几十年来，邻苯二甲酸二（2-乙基己基）酯（DEHP）一直是用于使聚氯乙烯（PVC）血袋柔韧的主要增塑剂。DEHP渗入血液制品，稳定红细胞（RBC）膜，防止过度溶血。尽管由于其潜在的内分泌干扰和致癌作用而被列为高度关注的物质，DEHP仍继续用于红细胞浓缩物（RCC）储存袋，因为替代品通常会导致RCC在储存过程中质量下降。然而，根据欧洲医疗器械法规，到2030年7月，医疗器械中DEHP的使用被限制在重量的0.1%以下。因此，最近研究了几种可选增塑剂对RCC质量的影响，如对苯二甲酸二（2-乙基己基）酯（DEHT）、1,2-环己烷二羧酸二异壬基酯（DINCH）和柠檬酸正丁基正己基（BTHC），它们与不同的储存溶液结合使用。尽管先前使用这些新组合的研究显示出不同的结果，但这些替代方案仍然是最有希望的选择，目前的数据表明，与DEHP相比，这些替代方案可以减少浸出和降低毒性。本综述重点介绍了从DEHP-PVC血袋系统向RCC存储过渡的关键出版物，证明了几种非dehp替代品是可行的替代选择，特别是与下一代存储解决方案相结合时。未来的研究需要评估不良事件的发生频率、泄漏等处理问题的发生情况，并通过输血后恢复和增量研究来评估实际性能和临床疗效。

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引用次数: 0

ADAMTS13 Testing During Clinical Remission of Immune Thrombotic Thrombocytopenic Purpura: A Critical Review 免疫血栓性血小板减少性紫癜临床缓解期间ADAMTS13检测：一项重要综述

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-04-01 DOI: 10.1016/j.tmrv.2025.150896

Danielle H. Robinson , Maple Huang , Diva Baggio , Giles Kelsey , Abbey Willcox , Kay Htun , Amanda K. Davis

Immune thrombotic thrombocytopenic purpura (iTTP), an autoimmune disorder characterised by thrombocytopenia and microangiopathic haemolytic anaemia, is associated with significant morbidity. The diagnosis is made when ADAMTS13 activity is <10% in conjunction with supporting clinical features. Treatment includes plasma exchange with immunosuppressive and anti-von Willebrand factor therapies. While diagnosis and management of acute iTTP are well established, our understanding of optimal monitoring during clinical remission remains incomplete. Clinical relapse of iTTP occurs most commonly within the first year of remission, however, there is little consensus as to the frequency of ADAMTS13 monitoring during clinical remission and when to intervene when there is ongoing deficiency. Through selecting studies that performed ADAMTS13 activity testing during clinical remission of iTTP we critically analyse the current research of ADAMTS13 monitoring during clinical remission and suggest areas for further research with a focus on clinically important outcomes.

免疫性血栓性血小板减少性紫癜（iTTP）是一种以血小板减少和微血管病变溶血性贫血为特征的自身免疫性疾病，发病率高。当ADAMTS13活性达到10%并结合相关临床特征时，即可做出诊断。治疗包括血浆置换免疫抑制和抗血管性血友病因子治疗。虽然急性iTTP的诊断和管理已经很好地建立，但我们对临床缓解期间最佳监测的理解仍然不完整。iTTP的临床复发最常发生在缓解的第一年，然而，对于临床缓解期间ADAMTS13监测的频率以及当持续缺乏时何时进行干预，几乎没有共识。通过选择在iTTP临床缓解期间进行ADAMTS13活性测试的研究，我们批判性地分析了目前在临床缓解期间监测ADAMTS13的研究，并提出了进一步研究的领域，重点关注临床重要结果。

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引用次数: 0

The Utility of a Critical Antibody Titer in Anti-K Alloimmunized Pregnancies: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy 关键抗体滴度在抗k异体免疫妊娠中的效用：诊断测试准确性的系统回顾和荟萃分析

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-04-01 DOI: 10.1016/j.tmrv.2025.150895

Jeremy W. Jacobs , Ronan P. Sugrue , Jerome Jeffrey Federspiel , Melissa C. Funaro , Brian D. Adkins , Garrett S. Booth , Masja de Haas , Jia Jennifer Ding , Danijela Drndarevic , Sejal Kabre , Shengxin Liu , Yolentha M. Slootweg , Eleonor Tiblad , Kenneth J. Moise Jr , Elizabeth A. Abels

Anti-Kell (anti-K) alloimmunization is a known cause of severe hemolytic disease of the fetus and newborn (HDFN), yet the utility of a critical maternal antibody titer in guiding clinical management remains debated. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of a maternal anti-K titer threshold of ≥8 for predicting the need for intrauterine intervention due to severe anti-K–mediated HDFN. In parallel, we characterized all reported cases of severe HDFN occurring in the setting of low maternal anti-K titers (<8). Studies were excluded if they lacked reported titers, did not include K-positive or K-unknown fetuses, failed to report fetal outcomes, or included interventions that could lower maternal alloantibody levels. Studies that assessed all alloimmunized patients meeting inclusion criteria were incorporated into a diagnostic test accuracy (DTA) meta-analysis; all eligible studies were included in a qualitative synthesis. Fifty-four studies, comprising 582 fetuses, met inclusion criteria. Of these, 6 studies (350 fetuses) were included in the DTA analysis, which demonstrated a pooled sensitivity of 97.0% (95% CI, 88.7%–99.2%) and specificity of 33.1% (95% CI, 27.9%–38.8%) for an anti-K titer ≥8. Among fetuses affected by severe HDFN, 98.6% (204/207) were associated with maternal anti-K titers ≥8. These findings suggest that severe disease is uncommon in the setting of low anti-K titers and support the use of a critical titer threshold to inform antenatal surveillance. Reevaluation of current clinical guidelines may be warranted in light of these data.

抗kell（抗k）同种异体免疫是胎儿和新生儿严重溶血性疾病（hddn）的已知原因，但关键母体抗体滴度在指导临床管理中的效用仍存在争议。我们进行了一项系统回顾和荟萃分析，以评估母体抗k滴度阈值≥8用于预测因严重抗k介导的HDFN而需要宫内干预的诊断准确性。同时，我们描述了所有报告的发生在低母体抗k滴度环境下的严重hdn病例（<8）。如果缺乏报告的滴度，不包括k阳性或k未知的胎儿，未报告胎儿结局，或包括可能降低母体同种异体抗体水平的干预措施，则排除研究。评估所有符合纳入标准的同种异体免疫患者的研究被纳入诊断测试准确性（DTA）荟萃分析；所有符合条件的研究纳入定性综合。54项研究，包括582名胎儿，符合纳入标准。其中，6项研究（350例胎儿）被纳入DTA分析，结果显示抗k滴度≥8的合并敏感性为97.0% (95% CI, 88.7%-99.2%)，特异性为33.1% （95% CI, 27.9%-38.8%）。在患有严重hdf的胎儿中，98.6%（204/207）与母体抗k滴度≥8相关。这些发现表明，严重的疾病是罕见的设置低抗k滴度和支持使用临界滴度阈值，以通知产前监测。根据这些数据，可能需要重新评估当前的临床指南。

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引用次数: 0

Identifying Modifiers of CAR T-Cell Therapeutic Efficacy and Safety: A Systematic Review and Individual Patient Data Meta-Analysis 识别CAR - t细胞治疗疗效和安全性的修饰因子：系统评价和个体患者数据荟萃分析

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-04-01 DOI: 10.1016/j.tmrv.2025.150897

Manoj M Lalu , Samuel Igweokpala , Natasha Kekre , Matthew S Jeffers , Joshua Montroy , Maryam Ghiasi , Kevin Hay , Scott McComb , Risini Weeratna , Harold Atkins , Brian Hutton , Ayel Yahya , Ashish Masurekar , Philippe Giguere , Elham Sabri , Mohamad Sobh , Dean A Fergusson

CAR T-cell therapy is effective in relapsed/refractory hematologic malignancies, but its use has been tempered by heterogeneity in response and safety outcomes. We performed individual patient data meta-analysis (IPDMA) of CAR T-cell therapy in patients with hematologic malignancies to explore whether patient-level factors modify therapeutic efficacy/safety. We searched MEDLINE, Embase, and Cochrane CENTRAL for relevant trials. IPD was collected and pooled from each included trial, and prevalence of outcomes among strata of potential modifiers was explored. Our primary outcome was complete response, and the secondary outcomes were cytokine release syndrome (CRS), and immune effector cell associated neurotoxicity syndrome (ICANS). We identified 89 trials comprising 2,331 patients for the IPDMA. Complete response proportion ranged from 25% to 75% depending on cancer type. Decreased complete response was seen in those that received bridging therapy compared to those that did not (34% vs 58%, RR:0.55, 95% CI:0.30-0.98), as well as with autologous cell sources compared to allogeneic sources (53% vs 67%, RR:0.61, 95% CI:0.43-0.87). Compared to CAR T-cell therapies targeting CD19 alone, therapies that combine CD19 targeting with additional targets such as CD20, CD22, CD30, CD33, LeY, NKG2D, or BCMA were associated with higher complete response rates (72% vs 58%, RR:1.69, 95% CI:1.15-2.50). Autologous cell sources demonstrated increased risk of ICANS relative to allogeneic sources (24% vs 3%, RR:10.48, 95% CI:1.87-58.57). Safety and efficacy of CAR T-cell therapy within specific cancer types was also affected by modifiers including bridging therapy, CAR T-cell source, CAR T-cell target, sex, age, number of cell infusions, co-stimulatory domain, and dose.

CAR - t细胞疗法对复发/难治性血液恶性肿瘤有效，但由于疗效和安全性结果的异质性，其使用受到了限制。我们对血液恶性肿瘤患者的CAR - t细胞治疗进行了个体患者数据荟萃分析（IPDMA），以探讨患者水平的因素是否会改变治疗疗效/安全性。我们检索了MEDLINE、Embase和Cochrane CENTRAL的相关试验。从每个纳入的试验中收集和汇总IPD，并探讨潜在修饰剂分层中结果的流行程度。我们的主要结局是完全缓解，次要结局是细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）。我们确定了89项试验，包括2331例IPDMA患者。完全缓解比例根据癌症类型从25%到75%不等。与未接受桥接治疗的患者相比，接受桥接治疗的患者完全缓解率降低（34% vs 58%, RR:0.55, 95% CI:0.30-0.98），自体细胞源与异体细胞源相比，完全缓解率降低（53% vs 67%, RR:0.61, 95% CI:0.43-0.87）。与单独靶向CD19的CAR - t细胞疗法相比，将CD19靶向与其他靶点（如CD20、CD22、CD30、CD33、LeY、NKG2D或BCMA）结合的疗法具有更高的完全缓解率（72% vs 58%, RR:1.69, 95% CI:1.15-2.50）。与异体细胞源相比，自体细胞源的ICANS风险增加（24% vs 3%, RR:10.48, 95% CI:1.87-58.57）。CAR - t细胞治疗在特定癌症类型中的安全性和有效性也受到修饰因子的影响，包括桥接治疗、CAR - t细胞来源、CAR - t细胞靶点、性别、年龄、细胞输注次数、共刺激域和剂量。

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引用次数: 0

Journal Club 杂志俱乐部

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-03-05 DOI: 10.1016/j.tmrv.2025.150892

引用次数: 0

Ultra-Restrictive Transfusion Thresholds in Critically Ill Adults: Are We Ready for the Next Step? 危重成人的超限制性输血阈值：我们准备好下一步了吗？

IF 2.7 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-02-18 DOI: 10.1016/j.tmrv.2025.150893

Caroline M. Schaap, Robert B. Klanderman, Anna-Linda Peters, Alexander P.J. Vlaar, Marcella C.A. Müller

Anemia is almost universal in critically ill patients, with 25% receiving blood transfusions as clinicians aim to prevent insufficient oxygen delivery. The current 'restrictive' hemoglobin (Hb) threshold of 7 g/dL for the nonbleeding critically ill population is supported by several landmark transfusion trials. While some trials have investigated lower transfusion thresholds, these were not conducted in this specific population. Transfusion is associated with various risks including transfusion-associated circulatory overload, transfusion-related acute lung injury, and hemolytic reactions. Moreover, transfusion products are scarce and expensive as they are produced from voluntary blood donations. Therefore, it is essential to limit blood transfusion to when absolutely necessary. Research indicates that several patient categories tolerate lower Hb levels than 7 g/dL. For instance, studies on acute hemodilution in healthy volunteers have shown that lower Hb levels do not lead to organ ischemia. Similarly, studies involving patients who refuse transfusions, often report lower Hb levels down to 5g/dL or less. These lower Hb levels appear to have limited impact on mortality or morbidity related outcomes. In patients with severe burns or hematological disorders, Hb levels below 7 g/dL are not associated with significant adverse outcomes. These findings suggest that the transfusion threshold for critically ill patients could potentially be lowered, as Hb levels under 7 g/dL do not inherently lead to increased mortality or morbidity. An individualized approach to deciding whether to transfuse or not might be best. This shift in transfusion practice could help reduce costs and minimize the risks associated with blood transfusions.

贫血在危重患者中几乎是普遍的，25%的患者接受输血，因为临床医生的目的是防止氧气输送不足。目前，无出血危重患者的“限制性”血红蛋白（Hb）阈值为7 g/dL，这得到了几项具有里程碑意义的输血试验的支持。虽然一些试验研究了较低的输血阈值，但这些试验并未在这一特定人群中进行。输血与多种风险相关，包括输血相关的循环负荷、输血相关的急性肺损伤和溶血反应。此外，输血产品稀缺且昂贵，因为它们是由自愿献血生产的。因此，在绝对必要的情况下限制输血是必要的。研究表明，一些患者类别可以耐受低于7 g/dL的Hb水平。例如，对健康志愿者急性血液稀释的研究表明，较低的Hb水平不会导致器官缺血。同样，涉及拒绝输血的患者的研究通常报告Hb水平降至5g/dL或更低。这些较低的Hb水平似乎对死亡率或发病率相关结果的影响有限。在严重烧伤或血液系统疾病患者中，Hb水平低于7 g/dL与显著不良结局无关。这些发现表明，危重患者的输血阈值可能会降低，因为Hb水平低于7 g/dL并不必然导致死亡率或发病率增加。个体化的方法来决定是否输血可能是最好的。输血实践的这一转变有助于降低成本并最大限度地减少与输血相关的风险。

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引用次数: 0

IF 2.5 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-01-01

引用次数: 0

IF 2.5 2区医学 Q2 HEMATOLOGY

Transfusion Medicine Reviews

Pub Date : 2025-01-01

引用次数: 0