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排序方式: 共有140条查询结果,搜索用时 15 毫秒
1.
目的 回顾性调查分析乙肝肝衰竭患者临床输注新鲜冰冻血浆(fresh frozen plasma,FFP)的资料,了解输注FFP对于改善预后的疗效。方法 查阅2009-12/2013-07在四川省人民医院住院的88例乙肝肝衰竭患者,观察时间为4周,根据观察期间是否输注FFP分为2组,对照组31例未输注FFP,治疗组57例输注FFP,比较2组患者住院4周后和入院时的终末期肝病模型(Model for end-stage liver disease,MELD)评分,分析是否输注FFP和血浆用量对预后的影响,综合评估患者临床转归。结果 对照组MELD评分差值1.74±12.12,治疗组MELD评分差值-0.46±8.03,2组比较差异无统计学意义(t’=-0.91,P〉0.05)。治疗组的血浆用量和MELD评分差值使用直线相关分析,直线相关系数r=0.11 P〉0.05,无直线相关关系。结论 输注FFP不能改善乙肝肝衰竭患者的预后,不推荐预防性应用。 相似文献
2.
Yvonne P.J. Bosch Raed Al DieriHugo ten Cate Patty J. NelemansSaartje Bloemen Bas de LaatCoenraad Hemker Patrick W. WeerwindJos G. Maessen Baheramsjah Mochtar 《Thrombosis research》2014
Introduction
Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) are susceptible to haemostatic disturbances. Monitoring the haemostatic capacity by conventional clotting tests is challenging.Materials and Methods
Thrombin generation (TG) by Calibrated Automated Thrombography, clotting tests and tissue factor pathway inhibitor (TFPI) measurements were performed to describe the relationship between haemostatic changes and alterations in these tests. Blood samples were collected before, during and after CPB. Furthermore, it was investigated whether TG measured intraoperatively, is associated with increased risk of bleeding postoperatively.Results
TG diminished significantly (p < 0.01) after heparinization in the presence and absence of platelets (37% and 50%) compared to baseline. After the start of CPB, TG elevated and persisted till the end of surgery but remained lower than preoperatively. Activated clotting time increased after heparinization and after the start of bypass compared to baseline (400% and 500%). Anti-FXa activity reduced on the start of CPB compared to the level after heparinization, to almost the baseline value following protamine reversal of heparin. The plasma levels of total and free TFPI elevated 9 and 14 fold during bypass and remained after protamine administration higher than preoperatively. Plasma D-dimer levels reduced (p < 0.01) when bypass started. However, a marked elevation was observed in the following time points. TG in platelet-rich plasma measured after heparinization and after the start of CPB associated (p < 0.05) with postoperative blood loss.Conclusions
TG can be determined during CPB despite the high heparinization level, it reflects the haemostatic capacity better than clotting-based assays and might better predict bleeding when performed intraoperatively. 相似文献3.
4.
Sumaiah J. Alarfaj Daniel H. Jarrell Asad E. Patanwala 《The American journal of emergency medicine》2018,36(12):2182-2186
Background
Prothrombin complex concentrate (PCC) is used as an alternative to fresh frozen plasma (FFP) for emergency bleeding. The primary objective of this study was to compare the time from order to start of administration between 3-factor PCC (PCC3), 4-factor (PCC4), and FFP in the emergency department (ED). The secondary objective was to evaluate the effect of an ED pharmacist on time to administration of PCCs.Methods
This was a single center three-arm retrospective cohort study. Adult patients in the ED with bleeding were included. The primary outcome measure was the time from order to administration, which was compared between PCC3, PCC4, and FFP. The time from order to administration was also compared when the ED pharmacist was involved versus not involved in the care of patients receiving PCC.Results
There were 90 patients included in the study cohort (30 in each group). The median age was 69 years (IQR 57–82 years), and 57% (n = 52) were male. The median time from order to administration was 36 min (IQR 20–58 min) for PCC3, 34 min (IQR 18–48 min) for PCC4, and 92 min (IQR 63–133) for FFP (PCC3 versus PCC4, p = 0.429; PCC3 versus FFP, p < 0.001; PCC4 versus FFP, p < 0.001). The median time from order to administration was significantly decreased when the ED pharmacist was involved (24 min [IQR 15–35 min] versus 42 min [IQR 32–59 min], p < 0.001).Conclusions
Time from order to administration is faster with PCC than FFP. ED pharmacist involvement decreases the time from order to administration of PCC. 相似文献5.
Immune response to autologous transfusion in healthy volunteers: WB versus packed RBCs and FFP 总被引:2,自引:0,他引:2
BACKGROUND: Storage of blood as packed RBCs and FFP is standard practice in allogeneic transfusion. Separation into components has been proposed for autologous transfusion, as well, but beneficial effects have not yet been shown. STUDY DESIGN AND METHODS: Twenty-four healthy male volunteers were randomly assigned to receive 1 unit of either autologous RBCs and FFP (RCP group) or WB (WB group) after 49 or 35 days of storage, respectively. The immune response was analyzed by ELISA for IL-6, C3a, terminal complement complex SC5b-9, TNF-alpha, and neopterin. Differential WBC counts and the phagocytosis of neutrophils and monocytes were measured by flow cytometry. RESULTS: Cell counts of monocytes (0.85 x 10(3) ng/microL) [corrected] and neutrophils (6.9 x 10(3) ng/microL) [corrected] increased 30 minutes after WB transfusion and then returned to close to the baseline values seen in the RCP group (0.47 and 2.9 x 10(3) ng/microL [corrected], respectively) throughout the monitored period (p<0.05). C3a (169 vs. 116 ng/microL) [corrected] and IL-6 (29 vs. 6 pg/mL) reached higher plasma concentrations in the WB group (n = 11) than in the RCP group (n = 10). Phagocytosis of opsonized Escherichia coli was increased in neutrophils and monocytes and lasted up to 7 days after the transfusion of whole blood. CONCLUSION: Autologous WB induces a modest immunomodulation, but this effect is not observed upon transfusion of autologous blood components. 相似文献
6.
目的探讨FFP在临床中应用的效果及临床科学、合理应用FFP的情况。方法收集2007年1月。2008年4月我院输注新鲜冷冻血浆(FFP)共200例(516次)的资料,分析临床医生输注FFP的目的;输注FFP的516例中有256例在输注前以及输注后8h内均检查了PT、APTT,根据现代FFP输注适应证标准,将256例分为非控制组56例和控制组200例,比较输注前及输注后8h内的Pr、APTT的检查结果并进行统计学分析。结果200例中临床医生输注FFP合理使用119例(59.5%),输注血浆1027U(72.4%),不合理使用81例(40.5%),输注血浆391U(27.6%);非控制组在输注FFP后的PT、APTT的值较输注前有缩短,但差异无统计学意义(P〉0.05);控制组在输注FFP后PT、APTT的值较输注前有明显缩短,差异有统计学意义(P〈0.05)。结论根据现代FFP输注适应证标准,合理使用FFP能有效纠正凝血因子缺乏所致的出血;科学、合理、有效使用新鲜冷冻血浆的意识仍待加强。 相似文献
7.
Khan H Belsher J Yilmaz M Afessa B Winters JL Moore SB Hubmayr RD Gajic O 《Chest》2007,131(5):1308-1314
BACKGROUND: Transfusion has long been identified as a risk factor for acute lung injury (ALI)/ARDS. No study has formally evaluated the transfusion of specific blood products as a risk factor for ALI/ARDS in critically ill medical patients. METHOD: In this single-center retrospective cohort study, 841 consecutive critically ill patients were studied for the development of ALI/ARDS. Patients who received blood product transfusions were compared with those who did not, in univariate and multivariate propensity analyses. RESULTS: Two hundred ninety-eight patients (35%) received blood transfusions. Transfused patients were older (mean [+/- SD] age, 67 +/- 17 years vs 62 +/- 19 years; p < 0.001) and had higher acute physiologic and chronic health evaluation (APACHE) III scores (74 +/- 32 vs 58 +/- 23; p < 0.001) than those who had not received transfusions. ALI/ARDS developed more commonly (25% vs 18%; p = 0.025) in patients exposed to transfusion. Seventeen patients received massive RBC transfusions (ie, > 10 U of blood transfused within 24 h), of whom 13 also received fresh-frozen plasma (FFP) and 11 received platelet transfusions. When adjusted for the probability of transfusion and other ALI/ARDS risk factors, any transfusion was associated with the development of ALI/ARDS (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.24 to 3.75). Among those patients receiving individual blood products, ALI/ARDS was more likely to develop in patients who received FFP transfusions (OR, 2.48; 95% CI, 1.29 to 4.74) and platelet transfusions (OR, 3.89; 95% CI, 1.36 to 11.52) than in those who received only RBC transfusions (OR, 1.39; 95% CI, 0.79 to 2.43). CONCLUSION: Transfusion is associated with an increased risk of the development of ALI/ARDS in critically ill medical patients. The risk is higher with transfusions of plasma-rich blood products, FFP, and platelets, than with RBCs. 相似文献
8.
The use of plasma in Sweden is relatively high compared to other countries in the European Union. An analysis of all transfusion recipients in Orebro county during the whole year 2000 was performed. There were 3159 transfusion recipients of whom 96% had a registered diagnosis and 50% had undergone a "true" operation. Seven hundred and eleven patients (23%) had received plasma. Significantly more operated than nonoperated and more men than women received plasma. The typical plasma recipient was a man undergoing cardiovascular surgery. In Sweden there are two main types of plasma components: fresh frozen (FFP) and nonfrozen liquid plasma stored for up to 14 days, both considered to be clinically equal for most indications. The quality of these components as well as stored thawed FFP has been studied. The major storage effect was cold-induced contact activation and thereby consumption of C1 esterase inhibitor (C1INH) by day 14 in 22%. The citrate content in plasma sustained the overall coagulation function over 14 days. Other studies have shown that the levels of FV and ADAMTS 13 after 14 days remain at 70% or more compared to those for FFP. Since it is immediately available, liquid, nonfrozen or thawed, plasma is of great value in emergencies. Quality criteria for plasma components need to be assessed against evidence based indications and published in guidelines. 相似文献
9.
Therapy with fresh frozen plasma (FFP) confers serious risks, such as contraction of blood‐borne viruses, allergic reaction, volume overload and development of alloantibodies. The aim of this study was to apply principles of pharmacokinetic (PK) modelling to individual factor content of FFP to optimize individualized dosing, while minimizing potential risks of therapy. We used PK modelling to successfully target individual factor replacement in an 8‐month‐old patient receiving FFP for treatment of a severe congenital factor V (FV) deficiency. The model fit for the FV activity vs. time data was excellent (r = 0.98) and the model accurately predicted FV activity during the intraoperative and postoperative period. Accurate PK modelling of individual factor activity in FFP has the potential to provide better targeted therapy, enabling clinicians to more precisely dose patients requiring coagulation products, while avoiding wasteful and expensive product overtreatment, minimizing potentially life‐threatening complications due to undertreatment and limiting harmful product‐associated risks. 相似文献
10.
目的研究全血在采集后快速降温至4—6℃,再储存,不同时间段制备的新鲜冰冻血浆(FFP)中凝血因子Ⅷ(FⅧ)和纤维蛋白原(Fib)含量的变化。方法随机选取无偿献血全血200 mL(7 min内采完)30份和400 mL(13 min内采完)150份,分为实验组和对照组(每组90份)。实验组全血采集后,降温至4—6℃再置于2—6℃储血冰箱;对照组全血采集后直接放入2—6℃储血冰箱。首先,观察2组全血降温至4—6℃所需要的时间;然后,2组均在采血后<6、6—12、12—18、18—24 h制备FFP,制备后2周内检测FⅧ含量和Fib含量。结果实验组与对照组的全血分别在采血后约3、16—18 h温度降至4—6℃;实验组与对照组FⅧ含量均随着制备时间延长而递减,差异有统计学意义(P<0.01);而2组Fib含量在24 h内均无统计学差异(P>0.05)。实验组在18—24 h时段FⅧ含量明显高于对照组(P<0.05)。另外,实验组合格率在80%以上,对照组12—18、18—24 h时段的合格率仅73%和53%,显著低于实验组(P<0.01)。结论全血快速降温至4—6... 相似文献