测量输血有效性的新方法。

IF 3.1 3区 医学 Q2 HEMATOLOGY Current Opinion in Hematology Pub Date : 2023-11-01 Epub Date: 2023-08-18 DOI:10.1097/MOH.0000000000000783
Marianne Elaine McPherson Yee, Ross M Fasano
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引用次数: 0

摘要

综述目的:本综述包括根据临床情况和输血指征对输血有效性的不同考虑。组织氧合、大脑代谢氧的使用和红细胞(RBC)的存活是有急性和慢性输血需求的个体输血有效性的重要因素。最近的发现:组织和大脑吸氧的非侵入性测量包括近红外光谱(NIRS)和专门的MRI序列。RBC存活时间点,包括24 h输血后的恢复、50%的恢复时间点和平均潜在寿命可以在输血前用红细胞的生物素标记准确测量。在不同的细胞表面密度下进行标记可以确定多个RBC群体的存活率。摘要:尽管过去的最佳输血阈值试验侧重于将Hb作为输血需求的单一标志物,但氧合(通过NIRS或专门的MRI)和红细胞存活率(通过生物素标记)的测量为根据患者的急性健康需求或慢性输血目标个性化输血决策提供了机会。
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Novel approaches to measure transfusion effectiveness.

Purpose of review: This review encompasses different considerations of transfusion effectiveness based upon clinical scenario and transfusion indication. Tissue oxygenation, cerebral metabolic oxygen use, and red blood cell (RBC) survival are important elements of transfusion effectiveness in individuals with acute and chronic transfusion requirements.

Recent findings: Noninvasive measures of tissue and cerebral oxygen extraction include near-infrared spectroscopy (NIRS) and specialized MRI sequences. RBC survival timepoints including 24 h posttransfusion recovery, 50% recovery timepoint, and mean potential lifespan may be accurately measured with biotin-labeling of RBC prior to transfusion. Labeling at different cell surface densities allows survival of multiple RBC populations to be determined.

Summary: Although past trials of optimal transfusion thresholds have focused on Hb as a singular marker for transfusion needs, measures of oxygenation (via NIRS or specialized MRI) and RBC survival (via biotin labeling) provide the opportunity to personalize transfusion decisions to individual patient's acute health needs or chronic transfusion goals.

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来源期刊
CiteScore
6.60
自引率
3.10%
发文量
78
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​​Current Opinion in Hematology is an easy-to-digest bimonthly journal covering the most interesting and important advances in the field of hematology. Its hand-picked selection of editors ensure the highest quality selection of unbiased review articles on themes from nine key subject areas, including myeloid biology, Vascular biology, hematopoiesis and erythroid system and its diseases.
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