四川大学学报（医学版）2023，Vol.54Issue(6)：1256-1262,7.DOI:10.12182/20230960507
腹部手术患者围术期六种低体温特征与异体红细胞输注的关联性分析
Correlation Between 6 Characteristics of Perioperative Hypothermia and Allogeneic Red Blood Cell Transfusion in Abdominal Surgery Patients
摘要
Abstract
Objective To explore the correlation between six characteristics of perioperative hypothermia and allogeneic red blood cell(RBC)transfusions in patients who underwent abdominal surgeries.Methods Patients who underwent abdominal surgeries at West China Hospital,Sichuan University between October 2019 and July 2021 were retrospectively enrolled.A wearable wireless temperature sensor was used to continuously monitor the core body temperature of patients throughout the perioperative period.The perioperative temperature nadir,maximum temperature loss,percentage of time with hypothermia,time-weigh ted average temperature,area under the curve(AUC)at 36 ℃,and AUC at 37 ℃ were calculated for the period from entering the operation room to 24 hours after the end of anesthesia.The restricted cubic spline(RCS)and multiple logistic regression models were used to explore the correlation between these temperature characteristics and perioperative allogeneic RBC transfusions.Results A total of 3119 patients were included in the study,with an allogeneic RBC transfusion rate of 2.8％.The RCS model showed that allogeneic RBC transfusion was associated with the perioperative temperature nadir(Poverall=0.048)and AUC at 36 ℃(Poverall=0.026)and no statistical significance was found in the nonlinear test.The association between allogeneic RBC transfusions and other temperature characteristics was not statistically significant.According to the RCS model results,cut-off points were taken to form groups based on the body temperature characteristics.Multivariate logistic regression showed that the perioperative temperature nadir＜35.5 ℃(odds ratio[OR]=2.47,95％confidence interval[CI]:1.21-5.03)and AUC at 36 ℃≥100 ℃·min(OR=2.24,95％CI:1.09-4.58)were associated with increased demand for allogeneic RBC transfusion.Conclusion Hypothermia is associated with an increased need for perioperative allogeneic RBC transfusions and has a cumulative effect over time.For patients at high risk of bleeding,attention should be paid to the prevention of perioperative hypothermia and reduction in the cumulative exposure to hypothermia,thereby reducing the need for blood transfusion.关键词
腹部手术/围术期低体温/输血/可穿戴设备/生命体征Key words
Abdominal surgery/Perioperative hypothermia/Blood transfusion/Wearable device/Vital signs引用本文复制引用
刘雨薇,梁诗琪,范美龄,龚仁蓉,李卡..腹部手术患者围术期六种低体温特征与异体红细胞输注的关联性分析[J].四川大学学报（医学版）,2023,54(6):1256-1262,7.基金项目
四川省科技厅重点研发计划项目(No.2021YFS0150和No.2023YFS0066)资助 （No.2021YFS0150和No.2023YFS0066）
