非溶血性急性输血反应:患者和血液制品特征的影响。

Postgraduate medicine Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI:10.1080/00325481.2024.2396797
Abdulkerim Yıldız, Gökhan Evren, Bilge Zihar, Samet Yaman
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摘要

背景:非溶血性急性输血反应(ATR非溶血性急性输血反应(ATR)一般不会致命,但会因血液制品的浪费而导致工作量和成本的严重增加:方法:对 2016 年 1 月至 2022 年 12 月这 7 年间的数据进行回顾性分析,以确定患者和产品特征与急性输血反应发生之间可能存在的关联:研究期间共输注了 113,666 份血液制品。共有 146 例 ATR,估计发生率为每 1000 例血液制品 1.28 例。最常见的 ATR 是轻度过敏反应(84 例,占 57.6%)。发生和未发生 ATR 的患者之间的血型分布没有统计学意义(p = 0.797)。热性非溶血性输血反应(FNHTR)在接受红细胞悬液(ES)输血的患者中更为常见,而新鲜冰冻血浆(FFP)则主要用于轻度过敏反应患者(发生 FNHTR 或 "其他 "的患者为 60 岁,P = 0.046):本研究结果表明,无论血型如何,老年患者输注 ES 时发生 FNHTR 的概率较高,而使用 FFP 时发生轻度过敏反应的概率较高。虽然 ATR 难以预防,但可以强调的是,如果临床医生在做出输血决定时牢记这些可能性,预测和管理可能会变得更加容易。
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Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics.

Background: Non-hemolytic acute transfusion reactions (ATRs) are generally not fatal, but they can cause serious increases in workload and costs as a result of blood product wastage.

Methods: A retrospective analysis was made of the data of the 7-year period between January 2016 and December 2022 to identify the possible associations between patient and product characteristics and the development of ATRs.

Results: A total of 113,666 blood products were transfused during the study period. There were 146 ATRs with an estimated rate of 1.28 per 1000 blood products administered. The most common ATR was mild allergic reactions (n = 84, 57.6%). No statistically significant relationship was found in blood group distribution between patients who had and did not develop ATR (p = 0.797). Febrile Non-hemolytic Transfusion Reaction (FNHTR) was more common in patients receiving erythrocyte suspension (ES) transfusion, and Fresh Frozen Plasma (FFP) was mostly used in those with mild allergic reactions (p < 0.001). Patient age was determined as > 60 years in those who developed FNHTR or 'others,' and < 60 years in patients with mild allergic reactions (p = 0.046).

Conclusion: The results of the current study demonstrated that regardless of blood group, the probability of developing FNHTR is high when ES is transfused in elderly patients, and the probability of developing mild allergic reaction is high when FFP is used. While recognizing that ATRs are difficult to prevent, it can be emphasized that prediction and management may become easier if clinicians keep these possibilities in mind when making transfusion decisions.

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