低滴度组O全血(LTOWB)在越来越多的儿科创伤和大出血输血方案中用作初始复苏液。关于小儿创伤患者输血后不良事件的数据很少。
在2013年5月至2020年8月期间,在入院24小时内查询了至少一个单位红细胞(RBC)(成分组)或LTOWB(LTOWB组)的儿科接受者的血库记录。排除早期死亡(<72小时)的受试者。对LTOWB和组分组进行倾向评分匹配。记录不良事件,包括输血反应,血栓栓塞,急性肾损伤,脓毒症,和基于PELOD-2评分的器官衰竭,以及医院和ICU住院时间(LOS)和呼吸机天数。
36名LTOWB接受者与36名常规成分接受者相匹配。受试者为52%的男性,钝性损伤机制(82%),中位数(IQR)损伤严重度评分=27(21-35),和26%的住院死亡率。两组在人口统计学和损伤特征方面非常匹配。包括报告的输血反应在内的不良结局没有临床或统计学上的显着差异。器官衰竭,急性肾损伤,脓毒症/菌血症,静脉血栓栓塞.医院LOS,呼吸机日,死亡率,出院时的功能障碍也没有显着差异。与组件组相比,LTOWB组的ICULOS明显较短。
LTOWB输血并未增加儿童不良事件的风险。然而,需要更大的研究来证实这些结果。
Low titer group O whole blood (LTOWB) is used as the initial resuscitative fluid in an increasing number of pediatric trauma and massive bleeding transfusion protocols. There is little data on adverse events following its transfusion in pediatric trauma patients.
Blood bank records were queried for pediatric recipients of at least one unit of red blood cells (RBCs) (component group) or LTOWB (LTOWB group) within 24 h of admission between May 2013 and August 2020. Subjects with early death (<72 h) were excluded. Propensity-score matching of LTOWB and component groups was performed. Adverse events were recorded, including transfusion reaction, thromboembolism, acute kidney injury, sepsis, and organ failure based on PELOD-2 score, along with hospital and ICU length of stay (LOS) and ventilator days.
Thirty-six LTOWB recipients were matched to 36 conventional component recipients. Subjects were 52% male, with blunt injury mechanism (82%), median (IQR) injury severity score = 27 (21-35), and 26% in-hospital mortality. The groups were well matched in terms of demographics and injury characteristics. There were no clinically or statistically significant differences in adverse outcomes including reported transfusion reaction, organ failure, acute kidney injury, sepsis/bacteremia, and venous thromboembolism. Hospital LOS, ventilator days, mortality, and functional disability at discharge were also not significantly different. The LTOWB group had significantly shorter ICU LOS compared to the component group.
LTOWB transfusion did not increase the risk of adverse events in children. However, larger studies are required to confirm these results.