Relationship between lactate and alkali deficiency and blood transfusion therapy in patients with traumatic hemorrhagic shock
Journal Title: Chinese Journal of Blood Transfusion - Year 2023, Vol 36, Issue 6
Abstract
Objective To explore the effect of lactate and alkali deficiency on the need for red blood cell transfusion in emergency of patients with traumatic hemorrhagic shock. Methods A total of 126 patients with traumatic hemorrhagic shock in our hospital from January 2019 to December 2021 were retrospectively analyzed, and the 99 cases with effective treatment were divided into two groups according to the outcome of blood transfusion within 24 hours after admission: non-transfusion group (n=36) and transfusion group (n=63). The changes of lactic acid (Lac), alkali deficiency (BE), hemoglobin (Hb), hematocrit (Hct) at admission, hemoglobin (Hb), hematocrit (Hct) 24 hours after admission and the length of stay in ICU were compared between the two groups. The binary logistic regression was used to analyze the risk factors of whether there was a need for blood transfusion at the time of emergency admission. The correlation between individual and combined indicators of each risk factor and the need for blood transfusion were analyzed by the receiver operating curve (ROC). Results The mean level of Lac (2.90±1.82) in the non-transfusion group at admission was lower than that in the transfusion group (5.80±2.83) (P<0.05), while BE、Hb and Hct (-1.76±3.24, 120.78±20.83, 35.76±6.11) were higher than those in the transfusion group (-5.91±4.69, 101.32±29.68, 29.97±8.48) (P<0.05). The mean levels of Hb and Hct in the two groups 24 hours after admission (92.75±16.66, 78.49±15.91) and (27.62±5.24, 22.60±4.74) were lower than those at admission (P<0.05). Binary logistic statistical analysis confirmed that Lac (OR=1.74, 95% CI 1.493-2.927, P<0.01), BE (OR=0.77, 95% CI 0.676-0.883, P<0.01), Hb (OR=0.97, 95% CI 0.954-0.989, P<0.01), Hct (OR=0.90, 95% CI 0.844=0.96, P<0.01) had guiding significance for patients with traumatic hemorrhagic shock to have red blood cell transfusion demand, and the increase of blood lactic acid was an independent risk factor (P<0.05), while age and gender had no significant effect on it(P>0.05)The maximum AUG of Lac and BE(0.875, 0.766) in predicting the need for emergency red blood cell transfusion in patients with traumatic hemorrhagic shock was significantly better than that of Hb and Hct (0.692, 0.682); the optimal threshold for Lac was >3.6 mmol/L, while the optimal threshold for Hb is ≤106 g/L; the maximum AUG obtained by ROC curve analysis combined with Lac, BE, Hb and Hct was 0.910, which was higher than that of the sole virable. Comparative predictive value using the optimal thresholds of Lac and Hb as indications for transfusion showed that Lac had better predictive value than Hb. Conclusion Lac and be can be instructive for patients with traumatic hemorrhagic shock as to whether they need red blood cell transfusion in an emergency setting, and combination of Lac, BE, Hb and Hct may help to determine the transfusion needs of patients more timely and accurately and optimize the transfusion management of emergency patients.
Authors and Affiliations
Xiaolin ZHANG, Shuangbao SU, Jianshe SHI, Yaojian WU
Keywords
Related Articles
- EP ID EP738569
- DOI 10.13303/j.cjbt.issn.1004-549x.2023.06.012
- Views 58
- Downloads 0
Study on RHD and RHCE gene mRNA based on three generation sequencing technology
Objective To establish RH gene mRNA sequencing method based on nanopores sequencing and to explore the RHD and RHCE mRNA transcripts in D positive and Del individuals. Methods From March 2021 to May 2022, 5 RhD positive...
A content analysis of the provincial laws and regulations for voluntary blood donation
Objective To perform quantitative analysis on the sample provincial laws and regulations for voluntary blood donation, and provide reference for further revision of laws and regulations. Methods 31 study samples were cur...
Risk factors analysis of blood type unexpected antibody in large sample of inpatients
Objective To observe and analyze the detection results of blood type unexpected antibody and its risk factors in inpatients, so as to provide reference for promoting the safety of clinical blood transfusion. Methods Clin...
Molecular genetics research of a Chinese family carrying triple HLA-A alleles
Objective To determine molecular basis of a rare HLA-A typing results carrying triple A alleles in potential allo-HSCT donor and her family. Methods HLA-A, -B, -C, -DRB1, -DQB1, -E, -F, -G of 5 members in the family were...
Perioperative allogenic blood transfusion for single disease in patients undergoing spinal deformity correction surgery:a longitudinal observational study
Objective To analyze the profile of perioperative allogenic blood transfusion for single disease in patients who underwent spinal deformity correction surgery and risk factors of the blood transfusion, in order to provid...