文摘
心脏手术的血液制品是最大的消费者医学;虽然相信救生,输血带来实质性不利的风险。本研究描述之间的关系输血,心脏手术后感染的主要风险。5158年,成年人前瞻性评估心脏手术后感染。最常见的程序被孤立的冠状动脉搭桥手术(31%)和隔离阀手术(30%);19%是手术。感染是由独立的传染病专家裁决。多变量Cox模型被用来评估的独立影响血液和血小板输血手术的主要感染60±5天内。红细胞(RBC)和血小板输血在48%和31%的病人,分别。每个红细胞单元输血与原油的主要感染风险增加29% (p < 0.001)。 Among RBC recipients, the most common infections were pneumonia (3.6%) and bloodstream infections (2%). Risk factors for infection included postoperative RBC units transfused, longer duration of surgery, and transplant or ventricular assist device implantation, in addition to chronic obstructive pulmonary disease, heart failure, and elevated preoperative creatinine. Platelet transfusion decreased the risk of infection (p = 0.02). Greater attention to management practices that limit RBC use, including cell salvage, small priming volumes, vacuum-assisted venous return with rapid autologous priming, and ultrafiltration, and preoperative and intraoperative measures to elevate hematocrit could potentially reduce occurrence of major postoperative infections.