輸血并發癥研究的新進展_West China Medical Journal

Authors：

 陳皎 , 廖刃 , 劉進

四川大學華西醫院麻醉科（成都, 610041）;

Corresponding?author：

Keywords：

輸血; 并發癥; 急性肺損傷; 預防

DOI：

10.7507/1002-0179.20140363

Video：

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輸血是一種重要的臨床治療手段。但合理的輸血一直是個難點，大量輸血有可能導致一系列的輸血不良反應，如何有效地進行輸血管理并降低輸血的風險一直是國內外學者重點探討的課題。在大量參考國內外輸血管理和并發癥相關文獻基礎上，現對近年來輸血并發癥新的認識作一綜述。

Citation： 陳皎, 廖刃, 劉進. 輸血并發癥研究的新進展. West China Medical Journal, 2014, 29(6): 1182-1187. doi: 10.7507/1002-0179.20140363 Copy

1.	童加斌, 鐘鶴鳴. 臨床用血[M]. 北京: 人民衛生出版社, 2005: 64-70.
2.	Donaldson M, Seaman MJ, Park GR. Massive blood transfusion[J]. Br J Anaesth, 1992, 69(6): 621-630.
3.	Sihler KC, Napolitano LM. Complications of massive transfusion[J]. Chest, 2010, 137(1): 209-220.
4.	Sihler KC, Napolitano LM. Massive transfusion: new insights[J]. Chest, 2009, 136(6): 1654-1667.
5.	Blajchman MA, Vamvakas EC. The continuing risk of transfusion-transmitted infections[J]. N Engl J Med, 2006, 355(13): 1303-1305.
6.	Stramer SL, Hollinger FB, Katz LM, et al. Emerging infectious disease agents and their potential threat to transfusion safety[J]. Transfusion, 2009, 49(Suppl 2): 1S-29S.
7.	Wallis JP. vCJD and blood transfusion[J]. Br J Haematol, 2009, 145(5): 669-670.
8.	Gajic O, Rana R, Winters JL, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study[J]. Am J Respir Crit Care Med, 2007, 176(9): 886-891.
9.	Marik PE, Corwin HL. Acute lung injury following blood transfusion: expanding the definition[J]. Crit Care Med, 2008, 36(11): 3080-3084.
10.	Williamson LM, Lowe S, Love EM, et al. Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports[J]. BMJ, 1999, 319(721): 16-19.
11.	Thomson A, Farmer S, Hofmann A, et al. Patient blood management-a new paradigm for transfusion medicine[J]. ISBT Sci Ser, 2009(4): 423-435.
12.	Rawn J. The silent risks of blood transfusion[J]. Curr Opin Anaesthesiol, 2008, 21(5): 664-668.
13.	Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature[J]. Crit Care Med, 2008, 36(9): 2667-2674.
14.	Bateman ST, Lacroix J, Boven K, et al. Anemia, blood loss, and blood transfusions in North American children in the intensive care unit[J]. Am J Respir Crit Care Med, 2008, 178(1): 26-33.
15.	Kim P, Dixon S, Eisenbrey AB, et al. Impact of acute blood loss anemia and red blood cell transfusion on mortality after percutaneous coronary intervention[J]. Clin Cardiol, 2007, 30(10 Suppl 2): Ⅱ35-Ⅱ43.
16.	Rao SV, Jollis JG, Harrington RA, et al. Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes[J]. JAMA, 2004, 292(13): 1555-1562.
17.	Taylor RW, Manganaro L, O' brien J, et al. Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient[J]. Crit Care Med, 2002, 30(10): 2249-2254.
18.	Shander A, Spence RK, Adams D, et al. Timing and incidence of postoperative infections associated with blood transfusion: analysis of 1,489 orthopedic and cardiac surgery patients[J]. Surg Infect (Larchmt), 2009, 10(3): 277-283.
19.	Engoren M, Mitchell E, Perring P, et al. The effect of erythrocyte blood transfusions on survival after surgery for hip fracture[J]. J Trauma, 2008, 65(6): 1411-1415.
20.	Malone DL, Dunne J, Tracy JK, et al. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma[J]. J Trauma, 2003, 54(5): 898-905.
21.	Croce MA, Tolley EA, Claridge JA, et al. Transfusions result in pulmonary morbidity and death after a moderate degree of injury[J]. J Trauma, 2005, 59(1): 19-23.
22.	Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery[J]. Circulation, 2007, 116(22): 2544-2552.
23.	Koch CG, Li L, Duncan AI, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting[J]. Crit Care Med, 2006, 34(6): 1608-1616.
24.	Koch CG, Khandwala F, Li L, et al. Persistent effect of red cell transfusion on health-related quality of life after cardiac surgery[J]. Ann Thorac Surg, 2006, 82(1): 13-20.
25.	Surgenor SD, Defoe GR, Fillinger MP, et al. Intraoperative red blood cell transfusion during coronary artery bypass graft surgery increases the risk of postoperative low-output heart failure[J]. Circulation, 2006, 114(1 Suppl): I43-I48.
26.	Corwin HL, Gettinger A, Pearl RG, et al. The CRIT study: anemia and blood transfusion in the critically ill--current clinical practice in the United States[J]. Crit Care Med, 2004, 32(1): 39-52.
27.	Dunne JR, Malone D, Tracy JK, et al. Perioperative anemia: an Independent risk factor for infection, mortality, and resource utilization in surgery[J]. J Surg Res, 2002, 102(2): 237-244.
28.	Kneyber MC, Hersi MI, Twisk JW, et al. Red blood cell transfusion in critically ill children is independently associated with increased mortality[J]. Intensive Care Med, 2007, 33(8): 1414-1422.
29.	Khorana AA, Francis CW, Blumberg N, et al. Blood transfusions, thrombosis, and mortality in hospitalized patients with cancer[J]. Arch Intern Med, 2008, 168(21): 2377-2381.
30.	Yang X, Alexander KP, Chen AY, et al. The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative[J]. J Am Coll Cardiol, 2005, 46(8): 1490-1495.
31.	Bernard AC, Davenport DL, Chang PK, et al. Intraoperative transfusion of 1 U to 2 U packed red blood cells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients[J]. J Am Coll Surg, 2009, 208(5): 931-937, 937.e1.
32.	Chaiwat O, Lang JD, Vavilala MS, et al. Early packed red blood cell transfusion and acute respiratory distress syndrome after trauma[J]. Anesthesiology, 2009, 110(2): 351-360.
33.	Leal-Noval SR, Rincón-Ferrari MD, García-Curiel A, et al. Transfusion of blood components and postoperative infection in patients undergoing cardiac surgery[J]. Chest, 2001, 119(5): 1461-1468.
34.	Koch CG, Li L, Sessler DI, et al. Duration of red-cell storage and complications after cardiac surgery[J]. N Engl J Med, 2008, 358(12): 1229-1239.
35.	Morton J, Anastassopoulos KP, Patel ST, et al. Frequency and outcomes of blood products transfusion across procedures and clinical conditions warranting inpatient care: an analysis of the 2004 healthcare cost and utilization project nationwide inpatient sample database[J]. Am J Med Qual, 2010, 25(4): 289-296.
36.	Glance LG, Dick AW, Mukamel DB, et al. Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery[J]. Anesthesiology, 2011, 114(2): 283-292.
37.	Engoren MC, Habib RH, Zacharias A, et al. Effect of blood transfusion on long-term survival after cardiac operation[J]. Ann Thorac Surg, 2002, 74(4): 1180-1186.
38.	Koch CG, Li L, Duncan AI, et al. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival[J]. Ann Thorac Surg, 2006, 81(5): 1650-1657.
39.	Surgenor SD, Kramer RS, Olmstead EM, et al. The association of perioperative red blood cell transfusions and decreased long-term survival after cardiac surgery[J]. Anesth Analg, 2009, 108(6): 1741-1746.
40.	Weightman WM, Gibbs NM, Sheminant MR, et al. Moderate exposure to allogeneic blood products is not associated with reduced long-term survival after surgery for coronary artery disease[J]. Anesthesiology, 2009, 111(2): 327-333.
41.	Rogers MA, Blumberg N, Saint SK, et al. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery[J]. Am Heart J, 2006, 152(6): 1028-1034.
42.	Kuduvalli M, Oo AY, Newall N, et al. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery[J]. Eur J Cardiothorac Surg, 2005, 27(4): 592-598.
43.	Engoren M, Arslanian-Engoren C. Long-term survival in the intensive care unit after erythrocyte blood transfusion[J]. Am J Crit Care, 2009, 18(2): 124-131.
44.	Varnado CL, Mollan TL, Birukou I, et al. Development of recombinant hemoglobin-based oxygen carriers[J]. Antioxid Redox Signal, 2013, 18(17): 2314-2328.
45.	Popovsky MA, Abel MD, Moore SB. Transfusion-related acute lung injury associated with passive transfer of antileukocyte antibodies[J]. Am Rev Respir Dis, 1983, 128(1): 185-189.
46.	Menis M, Izurieta HS, Anderson SA, et al. Outpatient transfusions and occurrence of serious noninfectious transfusion-related complications among US elderly, 2007-2008: utility of large administrative databases in blood safety research[J]. Transfusion, 2012, 52(9): 1968-1976.
47.	Alter HJ, Klein HG. The hazards of blood transfusion in historical perspective[J]. Blood, 2008, 112(7): 2617-2626.
48.	Toy P, Gajic O, Bacchetti P, et al. Transfusion-related acute lung injury: incidence and risk factors[J]. Blood, 2012, 119(7): 1757-1767.
49.	Chapman CE, Stainsby D, Jones H, et al. Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma[J]. Transfusion, 2009, 49(3): 440-452.
50.	Toy P, Popovsky MA, Abraham E, et al. Transfusion-related acute lung injury: definition and review[J]. Crit Care Med, 2005, 33(4): 721-726.
51.	王振義, 李家增, 阮長耿, 等. 血液制品的應用[M]. 3版. 上海: 上海科學技術出版社, 2004: 825-856.
52.	鄧家棟, 楊崇禮, 楊天楹, 等. 全血和血細胞的臨床應用[M]. 上海: 上海科學技術出版社, 2001: 1626-1641.
53.	何廣勝, 王雪明. 輸血治療[M]//阮長耿,吳德沛,李建勇,等. 現代血液病診斷治療學. 合肥: 安徽科學技術出版社, 2007: 518-521.
54.	Dodd RY. Current risk for transfusion transmitted infections[J]. Curr Opin Hematol, 2007, 14(6): 671-676.
55.	Shander A. Emerging risks and outcomes of blood transfusion in surgery[J]. Semin Hematol, 2004, 41(1 Suppl 1): 117-124.
56.	Warrell D, Cox TM, Firth JD, et al. Oxford textbook of medicine[M]. New York : Oxford University Press, 2003: 791-800.
57.	中華人民共和國衛生部. 臨床輸血技術規范[J]. 柳州醫學, 2012(1): 75-77.
58.	鄧碩曾, 宋海波, 劉進. 循證輸血與輸血指南[J]. 中國輸血雜志, 2006, 19(4): 263-264.

1. 童加斌, 鐘鶴鳴. 臨床用血[M]. 北京: 人民衛生出版社, 2005: 64-70.
2. Donaldson M, Seaman MJ, Park GR. Massive blood transfusion[J]. Br J Anaesth, 1992, 69(6): 621-630.
3. Sihler KC, Napolitano LM. Complications of massive transfusion[J]. Chest, 2010, 137(1): 209-220.
4. Sihler KC, Napolitano LM. Massive transfusion: new insights[J]. Chest, 2009, 136(6): 1654-1667.
5. Blajchman MA, Vamvakas EC. The continuing risk of transfusion-transmitted infections[J]. N Engl J Med, 2006, 355(13): 1303-1305.
6. Stramer SL, Hollinger FB, Katz LM, et al. Emerging infectious disease agents and their potential threat to transfusion safety[J]. Transfusion, 2009, 49(Suppl 2): 1S-29S.
7. Wallis JP. vCJD and blood transfusion[J]. Br J Haematol, 2009, 145(5): 669-670.
8. Gajic O, Rana R, Winters JL, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study[J]. Am J Respir Crit Care Med, 2007, 176(9): 886-891.
9. Marik PE, Corwin HL. Acute lung injury following blood transfusion: expanding the definition[J]. Crit Care Med, 2008, 36(11): 3080-3084.
10. Williamson LM, Lowe S, Love EM, et al. Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports[J]. BMJ, 1999, 319(721): 16-19.
11. Thomson A, Farmer S, Hofmann A, et al. Patient blood management-a new paradigm for transfusion medicine[J]. ISBT Sci Ser, 2009(4): 423-435.
12. Rawn J. The silent risks of blood transfusion[J]. Curr Opin Anaesthesiol, 2008, 21(5): 664-668.
13. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature[J]. Crit Care Med, 2008, 36(9): 2667-2674.
14. Bateman ST, Lacroix J, Boven K, et al. Anemia, blood loss, and blood transfusions in North American children in the intensive care unit[J]. Am J Respir Crit Care Med, 2008, 178(1): 26-33.
15. Kim P, Dixon S, Eisenbrey AB, et al. Impact of acute blood loss anemia and red blood cell transfusion on mortality after percutaneous coronary intervention[J]. Clin Cardiol, 2007, 30(10 Suppl 2): Ⅱ35-Ⅱ43.
16. Rao SV, Jollis JG, Harrington RA, et al. Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes[J]. JAMA, 2004, 292(13): 1555-1562.
17. Taylor RW, Manganaro L, O' brien J, et al. Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient[J]. Crit Care Med, 2002, 30(10): 2249-2254.
18. Shander A, Spence RK, Adams D, et al. Timing and incidence of postoperative infections associated with blood transfusion: analysis of 1,489 orthopedic and cardiac surgery patients[J]. Surg Infect (Larchmt), 2009, 10(3): 277-283.
19. Engoren M, Mitchell E, Perring P, et al. The effect of erythrocyte blood transfusions on survival after surgery for hip fracture[J]. J Trauma, 2008, 65(6): 1411-1415.
20. Malone DL, Dunne J, Tracy JK, et al. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma[J]. J Trauma, 2003, 54(5): 898-905.
21. Croce MA, Tolley EA, Claridge JA, et al. Transfusions result in pulmonary morbidity and death after a moderate degree of injury[J]. J Trauma, 2005, 59(1): 19-23.
22. Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery[J]. Circulation, 2007, 116(22): 2544-2552.
23. Koch CG, Li L, Duncan AI, et al. Morbidity and mortality risk associated with red blood cell and blood-component transfusion in isolated coronary artery bypass grafting[J]. Crit Care Med, 2006, 34(6): 1608-1616.
24. Koch CG, Khandwala F, Li L, et al. Persistent effect of red cell transfusion on health-related quality of life after cardiac surgery[J]. Ann Thorac Surg, 2006, 82(1): 13-20.
25. Surgenor SD, Defoe GR, Fillinger MP, et al. Intraoperative red blood cell transfusion during coronary artery bypass graft surgery increases the risk of postoperative low-output heart failure[J]. Circulation, 2006, 114(1 Suppl): I43-I48.
26. Corwin HL, Gettinger A, Pearl RG, et al. The CRIT study: anemia and blood transfusion in the critically ill--current clinical practice in the United States[J]. Crit Care Med, 2004, 32(1): 39-52.
27. Dunne JR, Malone D, Tracy JK, et al. Perioperative anemia: an Independent risk factor for infection, mortality, and resource utilization in surgery[J]. J Surg Res, 2002, 102(2): 237-244.
28. Kneyber MC, Hersi MI, Twisk JW, et al. Red blood cell transfusion in critically ill children is independently associated with increased mortality[J]. Intensive Care Med, 2007, 33(8): 1414-1422.
29. Khorana AA, Francis CW, Blumberg N, et al. Blood transfusions, thrombosis, and mortality in hospitalized patients with cancer[J]. Arch Intern Med, 2008, 168(21): 2377-2381.
30. Yang X, Alexander KP, Chen AY, et al. The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative[J]. J Am Coll Cardiol, 2005, 46(8): 1490-1495.
31. Bernard AC, Davenport DL, Chang PK, et al. Intraoperative transfusion of 1 U to 2 U packed red blood cells is associated with increased 30-day mortality, surgical-site infection, pneumonia, and sepsis in general surgery patients[J]. J Am Coll Surg, 2009, 208(5): 931-937, 937.e1.
32. Chaiwat O, Lang JD, Vavilala MS, et al. Early packed red blood cell transfusion and acute respiratory distress syndrome after trauma[J]. Anesthesiology, 2009, 110(2): 351-360.
33. Leal-Noval SR, Rincón-Ferrari MD, García-Curiel A, et al. Transfusion of blood components and postoperative infection in patients undergoing cardiac surgery[J]. Chest, 2001, 119(5): 1461-1468.
34. Koch CG, Li L, Sessler DI, et al. Duration of red-cell storage and complications after cardiac surgery[J]. N Engl J Med, 2008, 358(12): 1229-1239.
35. Morton J, Anastassopoulos KP, Patel ST, et al. Frequency and outcomes of blood products transfusion across procedures and clinical conditions warranting inpatient care: an analysis of the 2004 healthcare cost and utilization project nationwide inpatient sample database[J]. Am J Med Qual, 2010, 25(4): 289-296.
36. Glance LG, Dick AW, Mukamel DB, et al. Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery[J]. Anesthesiology, 2011, 114(2): 283-292.
37. Engoren MC, Habib RH, Zacharias A, et al. Effect of blood transfusion on long-term survival after cardiac operation[J]. Ann Thorac Surg, 2002, 74(4): 1180-1186.
38. Koch CG, Li L, Duncan AI, et al. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival[J]. Ann Thorac Surg, 2006, 81(5): 1650-1657.
39. Surgenor SD, Kramer RS, Olmstead EM, et al. The association of perioperative red blood cell transfusions and decreased long-term survival after cardiac surgery[J]. Anesth Analg, 2009, 108(6): 1741-1746.
40. Weightman WM, Gibbs NM, Sheminant MR, et al. Moderate exposure to allogeneic blood products is not associated with reduced long-term survival after surgery for coronary artery disease[J]. Anesthesiology, 2009, 111(2): 327-333.
41. Rogers MA, Blumberg N, Saint SK, et al. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery[J]. Am Heart J, 2006, 152(6): 1028-1034.
42. Kuduvalli M, Oo AY, Newall N, et al. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery[J]. Eur J Cardiothorac Surg, 2005, 27(4): 592-598.
43. Engoren M, Arslanian-Engoren C. Long-term survival in the intensive care unit after erythrocyte blood transfusion[J]. Am J Crit Care, 2009, 18(2): 124-131.
44. Varnado CL, Mollan TL, Birukou I, et al. Development of recombinant hemoglobin-based oxygen carriers[J]. Antioxid Redox Signal, 2013, 18(17): 2314-2328.
45. Popovsky MA, Abel MD, Moore SB. Transfusion-related acute lung injury associated with passive transfer of antileukocyte antibodies[J]. Am Rev Respir Dis, 1983, 128(1): 185-189.
46. Menis M, Izurieta HS, Anderson SA, et al. Outpatient transfusions and occurrence of serious noninfectious transfusion-related complications among US elderly, 2007-2008: utility of large administrative databases in blood safety research[J]. Transfusion, 2012, 52(9): 1968-1976.
47. Alter HJ, Klein HG. The hazards of blood transfusion in historical perspective[J]. Blood, 2008, 112(7): 2617-2626.
48. Toy P, Gajic O, Bacchetti P, et al. Transfusion-related acute lung injury: incidence and risk factors[J]. Blood, 2012, 119(7): 1757-1767.
49. Chapman CE, Stainsby D, Jones H, et al. Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma[J]. Transfusion, 2009, 49(3): 440-452.
50. Toy P, Popovsky MA, Abraham E, et al. Transfusion-related acute lung injury: definition and review[J]. Crit Care Med, 2005, 33(4): 721-726.
51. 王振義, 李家增, 阮長耿, 等. 血液制品的應用[M]. 3版. 上海: 上海科學技術出版社, 2004: 825-856.
52. 鄧家棟, 楊崇禮, 楊天楹, 等. 全血和血細胞的臨床應用[M]. 上海: 上海科學技術出版社, 2001: 1626-1641.
53. 何廣勝, 王雪明. 輸血治療[M]//阮長耿,吳德沛,李建勇,等. 現代血液病診斷治療學. 合肥: 安徽科學技術出版社, 2007: 518-521.
54. Dodd RY. Current risk for transfusion transmitted infections[J]. Curr Opin Hematol, 2007, 14(6): 671-676.
55. Shander A. Emerging risks and outcomes of blood transfusion in surgery[J]. Semin Hematol, 2004, 41(1 Suppl 1): 117-124.
56. Warrell D, Cox TM, Firth JD, et al. Oxford textbook of medicine[M]. New York : Oxford University Press, 2003: 791-800.
57. 中華人民共和國衛生部. 臨床輸血技術規范[J]. 柳州醫學, 2012(1): 75-77.
58. 鄧碩曾, 宋海波, 劉進. 循證輸血與輸血指南[J]. 中國輸血雜志, 2006, 19(4): 263-264.

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