中国实用儿科杂志

中国实用儿科杂志 ›› 2022, Vol. 37 ›› Issue (9): 650-655.DOI: 10.19538/j.ek2022090602

• 指南解读 • 上一篇    下一篇

《儿科重症监护输血和贫血专家倡议-控制/防止出血：危重儿童血浆和血小板输注实践的建议和专家共识》解读

  

  1. 浙江大学医学院附属儿童医院儿童重症监护室  国家儿童健康与疾病临床医学研究中心，浙江  杭州  310052
  • 出版日期:2022-09-06 发布日期:2022-09-27
  • 通讯作者: 张晨美，电子信箱: chzcm@zju.edu.cn

An introduction to the Consensus Recommendations for Plasma and Platelet Transfusion Practice in Critically Ill Children：From the Transfusion and Anemia Expertise Initiative—Control/Avoidance of Bleeding （TAXI-CAB）

  1. Department of Pediatric Intensive Care Unit，the Children’s Hospital，Zhejiang University School of Medicine； National Clinical Research Center for Child Health，Hangzhou  310052，China
  • Online:2022-09-06 Published:2022-09-27

摘要： 危重症患儿出血风险高，血小板及血浆输注是儿科重症监护病房（pediatric intensive care unit，PICU）常用治疗措施之一，在挽救患儿生命的同时，也带来输血相关性不良反应。为促进危重症患儿合理输注血浆和血小板，儿科重症监护输血和贫血专家倡议-控制/防止出血（transfusion and anemia expertise initiative，TAXI）专家组于2022年制订了危重儿童血浆和血小板输注实践的建议和专家共识。共识由7篇独立文章组成，包括共识推荐意见汇总1篇，涉及严重创伤、颅内出血或创伤性脑损伤、体外循环（cardiopulmonary bypass，CBP）手术、体外膜氧合、肿瘤性疾病和造血干细胞移植、急性肝功能衰竭或肝移植、非心脏手术、手术室外侵入性手术、脓毒症和（或）弥漫性血管内凝血共8类特殊危重人群的血浆和血小板输注的专家共识4篇及2篇补充内容分别为实验室检查、血浆和血小板的选择与处理、危重儿童血浆和血小板输注策略的研究优先事项，最终形成53项推荐意见，其中4项基于循证医学证据，5项良好实践声明及44项基于专家共识。该文仅介绍临床推荐意见。

关键词: 儿童, 危重症, 血浆输注, 血小板输注

Abstract: Critical illness increases risk of bleeding，and the transfusion of plasma and platelet is a commonly used treatment in the Pediatric Intensive Care Unit（PICU）. While saving the lives of the children with critical illness，it also brings serious blood transfusion-related harm to the children. In order to promote reasonable plasma and platelet transfusion. Transfusion and Anemia Expertise Initiative（TAXI）panel worked out the Consensus Recommendations for Plasma and Platelet Transfusion Practice in Critically Ill Children in 2022. The consensus is composed of seven independent articles：one of them is a summary of the consensus recommendations；four of them deal with the recommendations on 8 specific subgroups respectively with general critical illness，（1.severe trauma，intracranial hemorrhage，or traumatic brain injury; 2. cardiopulmonary bypass surgery; 3. extracorporeal membrane oxygenation; 4.oncologic diseases and hematopoietic stem cell transplantation; 5. acute liver failure or liver transplantation; 6.noncardiac surgery; 7. invasive procedures outside the operating room;8. sepsis and/or disseminated intravascular coagulation）；the other two are the laboratory assays， selection/processing of plasma and platelet components，the research priorities for plasma and platelet transfusion strategies in critically ill children. There are fifty-three specific recommendations totally，of which four are evidence-based，five are good practice statement and forty-four are expert consensus.This article only introduces the clinical recommendations.

Key words: child ;critical illness；plasma transfusion, platelet transfusion