Study on the ratio of blood transfusion components in disseminated intravascular coagulation caused by sever postpartum hemorrhage
Journal Title: Chinese Journal of Blood Transfusion - Year 2022, Vol 35, Issue 7
Abstract
Objective To investigate the transfusion ratio of plasma to RBC suspension during DIC caused by sever postpartum hemorrhage, so as to improve the clinical blood transfusion protocol. Methods A total of 82 parturients, who gave birth in our obstetrics department from January 2008 to December 2019 and treated successfully for DIC due to sever postpartum hemorrhage, were selected for the study. According to the plasma/RBC suspension ratio range (from 0.4 to 2.0) during DIC rescue, the included population was divided into four groups according to the ratio interval of 0.4: Group 1: 0.4~0.8 (13 people, median 0.7), Group 2 : 0.8~1.2(30 people, median 1.0), Group 3: 1.2~1.6(30 people, median 1.3), and Group 4: 1.6~2.0 (9 people, median 1.8). The general conditions, way of delivery, number of uterine artery perfusion embolization and surgical operations performed in the 4 groups were recorded. Once spontaneous postpartum hemorrhage occurred, blood cell analysis and coagulation function examinations were carried out every 1 to 2 hours until the condition was stable. The 24-hour blood loss, transfusion units of RBC suspension, fresh frozen plasma(FFP), platelet apheresis and fibrinogen during DIC and throughout the rescue of 4 groups were recorded and compared. Locally Weighted Regression (Lowess) method was applied to analyze the nonlinear association between the plasma/RBC suspension ratio and the duration of DIC, according to the duration of DIC in 4 groups. Results 1) The shortest duration of DIC (326.15 min) was observed in DIC patients transfused with a plasma/ red blood cell suspension ratio=1.8. The duration of DIC (min) in the four groups were 505.21±259.53, 435.67±307.18, 420.93±259.43, and 247.86±215.77, respectively (P<0.05). 2) The coagulation indexes PT(s), INR, APTT(s) and Fib(g/L) gradually recovered between 2.9~13.9 h after transfusion in all four groups, especially in group 4 (median plasma/RBC suspension ratio of 1.8), whose changes were most pronounced in PT, INR, and Fib at 4.3 h, 2.9 h, and 5 h, respectively (P<0.05). Conclusion Fresh frozen plasma should be given as early as possible during blood transfusion treatment of DIC rescue. The increase of the ratio of plasma/RBC suspension is beneficial to the early recovery of DIC, and the optimal ratio of plasma to RBC suspension is 1.8.
Authors and Affiliations
Ruizhe JIA, Zhaoer YU, Dan YAO, Mingming GAO, Xiang YU, Hongjuan DING
Keywords
Related Articles
- EP ID EP738287
- DOI 10.13303/j.cjbt.issn.1004-549x.2022.07.007
- Views 44
- Downloads 0
Serological and molecular biological characteristics of hepatitis B vaccinated donors with asymptomatic chronical infection in Shenzhen
Objective To investigate asymptomatic infection of hepatitis B virus(HBV) among hepatitis B vaccinated donors in Shenzhen, and analyze its serological and molecular characteristics. Methods The HBsAg ELISA positive blood...
Hemolytic transfusion reaction analysis and domestic literature review
Objective To investigate the causes of hemolytic transfusion reaction (HTR), identify clinical symptoms and severity, explore clinical detection methods, so as to provide reference for safe and rational blood use. Method...
Relationship between lactate and alkali deficiency and blood transfusion therapy in patients with traumatic hemorrhagic shock
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 hemorr...
Application of platelet-rich plasma in assisted reproductive technology
Assisted reproductive technology(ART) faces challenges such as low embryo implantation rates due to uterine factors, and infertility caused by ovarian function suppression and abnormal semen. Platelet-rich plasma(PRP), w...
Changes in related parameters after secondary preparation of blood components
Objective To study the changes in related parameters after secondary preparation of blood components, in order to further improve the quality of blood components. Methods Different centrifugation conditions were selected...