输血并发症研究的新进展_West China Medical Journal

Authors：

 陈皎 , 廖刃 , 刘进

四川大学华西医院麻醉科（成都, 610041）;

Corresponding author：

Keywords：

输血; 并发症; 急性肺损伤; 预防

DOI：

10.7507/1002-0179.20140363

Video：

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输血是一种重要的临床治疗手段。但合理的输血一直是个难点，大量输血有可能导致一系列的输血不良反应，如何有效地进行输血管理并降低输血的风险一直是国内外学者重点探讨的课题。在大量参考国内外输血管理和并发症相关文献基础上，现对近年来输血并发症新的认识作一综述。

Citation： 陈皎, 廖刃, 刘进. 输血并发症研究的新进展. West China Medical Journal, 2014, 29(6): 1182-1187. doi: 10.7507/1002-0179.20140363 Copy

1.	童加斌, 钟鹤鸣. 临床用血[M]. 北京: 人民卫生出版社, 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.	王振义, 李家增, 阮长耿, 等. 血液制品的应用[M]. 3版. 上海: 上海科学技术出版社, 2004: 825-856.
52.	邓家栋, 杨崇礼, 杨天楹, 等. 全血和血细胞的临床应用[M]. 上海: 上海科学技术出版社, 2001: 1626-1641.
53.	何广胜, 王雪明. 输血治疗[M]//阮长耿,吴德沛,李建勇,等. 现代血液病诊断治疗学. 合肥: 安徽科学技术出版社, 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.	中华人民共和国卫生部. 临床输血技术规范[J]. 柳州医学, 2012(1): 75-77.
58.	邓硕曾, 宋海波, 刘进. 循证输血与输血指南[J]. 中国输血杂志, 2006, 19(4): 263-264.

1. 童加斌, 钟鹤鸣. 临床用血[M]. 北京: 人民卫生出版社, 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. 王振义, 李家增, 阮长耿, 等. 血液制品的应用[M]. 3版. 上海: 上海科学技术出版社, 2004: 825-856.
52. 邓家栋, 杨崇礼, 杨天楹, 等. 全血和血细胞的临床应用[M]. 上海: 上海科学技术出版社, 2001: 1626-1641.
53. 何广胜, 王雪明. 输血治疗[M]//阮长耿,吴德沛,李建勇,等. 现代血液病诊断治疗学. 合肥: 安徽科学技术出版社, 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. 中华人民共和国卫生部. 临床输血技术规范[J]. 柳州医学, 2012(1): 75-77.
58. 邓硕曾, 宋海波, 刘进. 循证输血与输血指南[J]. 中国输血杂志, 2006, 19(4): 263-264.

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