输血医学的发展:肺部输血反应和新型血细胞标记技术。

Philippa G Phelp,Stefan F van Wonderen,Alexander P J Vlaar,Rick Kapur,Robert B Klanderman
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引用次数: 0

摘要

了解输血医学的最新进展至关重要,尤其是在重症监护和围手术期环境中,及时准确的输血可成为挽救生命的治疗干预措施。这篇叙述性综述探讨了输血相关不良事件的现状,重点关注肺部输血反应,如输血相关循环负荷过重(TACO)和输血相关急性肺损伤(TRALI)。输血相关循环负荷过重(TACO)和输血相关急性肺损伤(TRALI)是输血相关发病率和死亡率的主要原因;然而,目前还缺乏具体的治疗方法。了解目前的发病率、诊断标准、发病机理、治疗和预防策略可帮助临床医生降低这些危及生命的并发症的发病率。综述讨论了新出现的致病机制,包括炎症在 TACO 中可能扮演的角色、逆转 TRALI 的机制以及 TACO 和 TRALI 的治疗靶点,强调了进一步研究以发现预防和治疗方法的必要性。尽管取得了进展,但我们对输血过程中发生的情况的了解仍有很大差距,这突出说明了改进监测方法的必要性。针对这一问题,本综述还介绍了输血医学中用于改善监测和质量评估的新型血细胞标记技术,从而有可能减少输血相关并发症。本文旨在为麻醉师、重症监护专家和输血医学专业人员提供有关输血医学领域最新进展和发展的最新信息。
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Developments in Transfusion Medicine: Pulmonary Transfusion Reactions and Novel Blood Cell Labeling Techniques.
Staying updated on advancements in transfusion medicine is crucial, especially in critical care and perioperative setting, where timely and accurate transfusions can be lifesaving therapeutic interventions. This narrative review explores the landscape of transfusion-related adverse events, focusing on pulmonary transfusion reactions such as transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI). TACO and TRALI are the leading causes of transfusion-related morbidity and mortality; however, specific treatments are lacking. Understanding the current incidence, diagnostic criteria, pathogenesis, treatment, and prevention strategies can equip clinicians to help reduce the incidence of these life-threatening complications. The review discusses emerging pathogenic mechanisms, including the possible role of inflammation in TACO and the mechanisms of reverse TRALI and therapeutic targets for TACO and TRALI, emphasizing the need for further research to uncover preventive and treatment modalities. Despite advancements, significant gaps remain in our understanding of what occurs during transfusions, highlighting the necessity for improved monitoring methods. To address this, the review also presents novel blood cell labeling techniques in transfusion medicine used for improving monitoring, quality assessment, and as a consequence, potentially reducing transfusion-related complications. This article aims to provide an update for anesthesiologists, critical care specialists, and transfusion medicine professionals regarding recent advancements and developments in the field of transfusion medicine.
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