成人心血管外科手术体外循环患者血液管理指南  

Guidelines on patient blood management for adult cardiovascular surgery under cardiopulmonary bypass

作　　者：杜磊[1] 周成斌[2] 吉冰洋 国家心血管系统疾病医疗质量控制中心体外循环与体外生命支持质控工作组 DU Lei;ZHOU Chengbin;JI Bingyang;Working Group on Extracorporeal Life Support,National Center for Cardiovascular Quality Improvement(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiopulmonary Bypass,Guangdong Provincial People's Hospital of Southern Medical University,Guangzhou,510100,P.R.China;Department of Cardiopulmonary Bypass,Fuwai Hospital,National Center of Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China;不详)

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]南方医科大学广东省人民医院体外循环科,广州510100 [3]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院体外循环中心,北京100037 [4]不详

出　　处：《中国胸心血管外科临床杂志》2024年第11期1547-1559,共13页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划(2023YFC2410305);四川大学华西医院1·3·5卓越发展计划(2017-120);中国心胸血管麻醉学会无输血手术专项行动;国家临床重点专科建设项目。

摘　　要：为了指导成人心血管外科手术体外循环患者血液管理的规范化开展,减少血资源的浪费、改善患者结局,国家心血管系统疾病医疗质量控制中心体外循环与体外生命支持质控工作组牵头,组织国内48位专家共同制定《成人心血管外科手术体外循环患者血液管理指南》。指南制定专家组基于调研和PICO(患者,干预措施,对照,结果)原则遴选4个方面13个临床问题,包括体外循环预充及液体管理、体外循环抗凝和监测、围体外循环期血液制品输注和自体血液回输;通过文献检索形成循证医学证据;采用推荐分级的评估、制定与评价(Grading of Recommendations Assessment,Development and Evaluation,GRADE)分级系统起草指南推荐意见;2023—2024年召开5次专家讨论会,最终形成19条推荐意见。Working Group on Extracorporeal Life Support,National Center for Cardiovascular Quality Improvement developed guidelines on patient blood management for adult cardiovascular surgery under cardiopulmonary bypass,aiming to standardize patient blood management in adult cardiovascular surgery under cardiopulmonary bypass,reduce blood resource consumption,and improve patients outcomes.Forty-eight domestic experts participated in the development of the guidelines.Based on prior investigation and the PICO(patient,intervention,control,outcome)principles,thirteen clinical questions from four aspects were selected,including priming and fluid management during cardiopulmonary bypass,anticoagulation and monitoring during cardiopulmonary bypass,peri-cardiopulmonary bypass blood product infusion,and autologous blood infusion.Systemic reviews to the thirteen questions were performed through literature search.Recommendations were drafted using the GRADE(Grading of Recommendations Assessment,Development and Evaluation)system.After five rounds of experts discussions between 2023 and 2024,19 recommendations were finally formed.

关 键 词：患者血液管理 体外循环 成人 心血管外科 指南 

分 类 号：R654.2[医药卫生—外科学]