大量输血注意事项

Title: Massive Transfusion Pearls

题目：大量输血注意事项

Author 作者: Michael Winters

• Massive transfusion (MT) is defined as the transfusion of at least 10 U of packed red blood cells (PRBCs) within 24 hours.

• 大量输血（MT）的定义是在24小时内至少输10个单位的浓缩红细胞（PRBCs）。

• While the optimal ratio of PRBCs, FFP, and platelets is not known, most use a 1:1:1 ratio.

• 虽然输PRBCs，冻干血浆（FFP）和血小板的最佳比例还不清除，最常使用的比例为1:1:1。

• Though scoring systems have been published to identify patients who may benefit from MT (ABC, TASH, McLaughlin), they have not been shown to be superior to clinical judgment.

• •虽然已有可识别对MT有益的患者的评分系统（ABC，TASH，麦克劳克林），但他们都没有被证明是优于临床判断的。

• A few pearls when implementing massive transfusion for the patient with traumatic shock:

• 在给创伤性休克病人实施大量输血时，有几个事情要注意：

• Monitor temperature and aggressively treat hypothermia.

• 监测温度并积极治疗体温过低。

• Monitor fibrinogen levels and replace with cryoprecipitate if needed.

• 监测纤维蛋白原水平，如果需要输冷沉淀液。

• Monitor calcium and potassium. MT can induce hypocalcemia and hyperkalemia.

• 监测血钙和钾。MT可诱发低钙血症和高钾血症。

• References 参考文献：

Elmer J, et al. Massive transfusion in traumatic shock. J Emerg Med 2013; 44:829-838.