目的:无细胞血红蛋白(CFH)是内皮功能障碍的有效介质,器官损伤,凝血病,和溶血的免疫调节。这些机制已在脓毒症患者中得到证实,血红蛋白病,和那些接受输血的人。然而,人们对CFH在创伤病理生理学中的作用知之甚少,尽管释放了同等水平的游离血红蛋白。
方法:OvidMEDLINE,Embase,WebofScience核心合集,截至2023年1月21日,我们使用与游离血红蛋白和创伤相关的关键术语搜索了BIOSIS预览.
方法:两名独立评审者选择的研究重点是创伤患者的溶血,血红蛋白分解产物,创伤中血红蛋白介导的损伤,输血,脓毒症,或治疗。
结果:所选研究及其参考文献的数据被合成为叙述性综述。
结论:游离血红蛋白可能在内皮功能障碍中起作用,器官损伤,凝血病,和多发性创伤的免疫功能障碍。这是一个引人注目的研究领域,因为多种现有疗法有效地阻断了这些途径。
OBJECTIVE: Cell-free hemoglobin (CFH) is a potent mediator of endothelial dysfunction, organ injury, coagulopathy, and immunomodulation in
hemolysis. These mechanisms have been demonstrated in patients with sepsis, hemoglobinopathies, and those receiving transfusions. However, less is known about the role of CFH in the pathophysiology of trauma, despite the release of equivalent levels of free hemoglobin.
METHODS: Ovid MEDLINE, Embase, Web of Science Core Collection, and BIOSIS Previews were searched up to January 21, 2023, using key terms related to free hemoglobin and trauma.
METHODS: Two independent reviewers selected studies focused on
hemolysis in trauma patients, hemoglobin breakdown products, hemoglobin-mediated injury in trauma, transfusion, sepsis, or therapeutics.
RESULTS: Data from the selected studies and their references were synthesized into a narrative
review.
CONCLUSIONS: Free hemoglobin likely plays a role in endothelial dysfunction, organ injury, coagulopathy, and immune dysfunction in polytrauma. This is a compelling area of investigation as multiple existing therapeutics effectively block these pathways.