41例新生儿体外膜肺氧合期间血液成分输注的回顾性分析*

doi:10.3969/j.issn.1671-2587.2022.02.012

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (2): 197-201.DOI: 10.3969/j.issn.1671-2587.2022.02.012

41例新生儿体外膜肺氧合期间血液成分输注的回顾性分析^*

全雪丽, 王洁, 王风, 成怡冰, 洪小杨, 赵喆, 陈应富, 刘成军

450018 郑州大学附属儿童医院（河南省儿童医院,郑州儿童医院）SICU（全雪丽,王洁,王风,成怡冰）; 北京解放军总医院第七医学中心八一儿童医院PICU （洪小杨,赵喆）; 重庆医科大学附属儿童医院PICU（陈应富刘成军）

收稿日期:2021-09-03 发布日期:2022-04-12
通讯作者: 成怡冰,女,主任医师,硕士,重症医学,（E-mail）13703829317@163.com。
作者简介:全雪丽（1987-）,女,河南南阳人,主治医师,硕士,主要从事重症医学研究工作,（E-mail）quanxueli2006@163.com
基金资助:
*本课题受首都卫生发展科研专项项目（No.2020-2-5093）资助

Blood Components Usage during Extracorporeal Membrane Oxygenation in 41 Neonates

QUAN Xue-li, WANG Jie, WANG Feng, et al

Surgical Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018

Received:2021-09-03 Published:2022-04-12

摘要/Abstract

摘要： 目的探讨新生儿体外膜肺氧合（extracorporeal membrane oxygenation,ECMO）期间血液成分使用情况。方法回顾性分析解放军总医院第七医学中心八一儿童医院、郑州大学附属儿童医院、重庆大学附属儿童医院的3家三级儿童专科医院ECMO中心,自2015年1月~2020年3月ECMO呼吸支持新生儿的临床资料,分别记录ECMO运行期间各种血液成分（悬浮红细胞、血浆、冷沉淀和血小板）输注量,并分析其对患儿院内病死率的影响。结果共41例纳入研究,根据出院转归,分为存活组（n=30）和死亡组（n=11）,院内病死率为26.8%。41例新生儿日血细胞比容维持在（34.1±3.59）%,接近正常水平,悬浮红细胞及血小板输注量较高,Logistic回归分析显示新生儿ECMO期间悬浮红细胞及血小板输注量增多是影响院内病死率的独立危险因素,OR值均为7.264（95%CI,1.266~41.674）。结论死亡组新生儿ECMO期间血液成分的使用量显著增加,其中悬浮红细胞及血小板输注量增多与患儿更高的院内病死率相关。

关键词: 输血, 体外膜肺氧合, 新生儿, 呼吸支持

Abstract: Objective To discuss blood component usage during extracorporeal membrane oxygenation（ECMO） in neonates. Method Medical records of neonates who underwent ECMO respiratory support between January 2015 and March 2020 were retrospectively analyzed in three ECMO centers, namely Bayi hildren's Hospital,Seventh Medical Center of PLA General Hospital, Children's Hospital affiliated to Zhengzhou University, and Children's Hospital Affiliated to Chongqing University. Patients received suspended red blood cells（SRBCs）, frozen plasma, cryoprecipitate and platelet during ECMO support. This study explores the relationship between the transfusion of blood components and hospital mortality. Result A total of 41 patients were included in the study. Based on discharge outcome, they were divided into survival group （n=30）and death group（n=11）, with a hospital mortality rate of 26.8%. Overall, the daily hematocrit was maintained at （34.1±3.59）% close to the normal level. The transfusion volume of SRBCs and platelet was higher. Logistic regression analysis showed that the increased transfusion of SRBCs and platelet during neonatal ECMO was an independent risk factor for hospital mortality, and OR values were both 7.264 （95%CI 1.266~41.674）. Conclusion The usage of blood components during ECMO in death group increased significantly, of which the increased amount of SRBCs and platelet transfusion was associated with higher in-hospital mortality.

Key words: Blood transfusion, Extracorporeal membrane oxygenation, Newborn, Respiration

中图分类号:

R457

全雪丽, 王洁, 王风, 成怡冰, 洪小杨, 赵喆, 陈应富, 刘成军. 41例新生儿体外膜肺氧合期间血液成分输注的回顾性分析^*[J]. 临床输血与检验, 2022, 24(2): 197-201.

QUAN Xue-li, WANG Jie, WANG Feng, et al. Blood Components Usage during Extracorporeal Membrane Oxygenation in 41 Neonates[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2022, 24(2): 197-201.

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41例新生儿体外膜肺氧合期间血液成分输注的回顾性分析^*

Blood Components Usage during Extracorporeal Membrane Oxygenation in 41 Neonates

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