{"title":"术中抢救性自体输血中输血负荷对肾功能的影响：200例患者的回顾性队列研究。","authors":"Honglan Wang, Meixin Zhang, Yu Gu, Weixin Zeng, Mei You, Wenxing Chen, Zhongshu Wu, Yahua Ye, Weitao Yu, Shuxuan Wang, Jingyang Zeng","doi":"10.3389/fphys.2025.1640701","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the effect of transfusion load on renal function during intraoperative salvage auto-transfusion.</p><p><strong>Methods: </strong>A total of 200 patients were assigned to five groups based on the transfusion load: 0-200 mL (Group A, n = 40), 201-400 mL (Group B, n = 40), 401-600 mL (Group C, n = 40), 601-800 mL (Group D, n = 40), >800 mL (Group E, n = 40). Serum creatinine (sCr) and free hemoglobin (FHb) concentrations were measured at preoperative baseline (T<sub>0</sub>), 1 h (T<sub>3</sub>), 2 h (T<sub>4</sub>), 12 h (T<sub>5</sub>), and 24 h (T<sub>6</sub>) post-auto-transfusion. FHb and sCr levels were also assessed in the blood storage tank before washed (T<sub>1</sub>) and in the reinfusion bag after washing (T<sub>2</sub>).</p><p><strong>Results: </strong>In Groups A, B, and C, there was no significant change in sCr levels between T0 and subsequent time points (T<sub>3</sub>, T<sub>4</sub>, T<sub>5</sub>, T<sub>6</sub>). However, in Groups D and E, sCr levels increased by more than 26.5 μmol/L from baseline at T<sub>3</sub> and T<sub>4</sub>, with sustained elevations at T<sub>3</sub>, T<sub>4</sub>, and T<sub>5</sub> compared to T0. FHb concentrations were higher in both T<sub>1</sub> and T<sub>2</sub> compared to T<sub>0</sub>, following a similar trend as sCr. Patients receiving more than 600 mL of autologous transfusion showed a transient increase in sCr at 1 and 2 h post-transfusion, consistent with acute kidney injury (AKI), which resolved by 24 h after transfusion.</p><p><strong>Conclusion: </strong>Attention should be paid to renal function in patients receiving large volumes (>600 mL) of salvaged blood during intraoperative auto-transfusion, as these patients may experience transient AKI, which resolves over time.</p>","PeriodicalId":12477,"journal":{"name":"Frontiers in Physiology","volume":"16 ","pages":"1640701"},"PeriodicalIF":3.2000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460466/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effects of transfusion load on renal function in intraoperative salvage autotransfusion: a retrospective cohort study for 200 patients.\",\"authors\":\"Honglan Wang, Meixin Zhang, Yu Gu, Weixin Zeng, Mei You, Wenxing Chen, Zhongshu Wu, Yahua Ye, Weitao Yu, Shuxuan Wang, Jingyang Zeng\",\"doi\":\"10.3389/fphys.2025.1640701\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to investigate the effect of transfusion load on renal function during intraoperative salvage auto-transfusion.</p><p><strong>Methods: </strong>A total of 200 patients were assigned to five groups based on the transfusion load: 0-200 mL (Group A, n = 40), 201-400 mL (Group B, n = 40), 401-600 mL (Group C, n = 40), 601-800 mL (Group D, n = 40), >800 mL (Group E, n = 40). Serum creatinine (sCr) and free hemoglobin (FHb) concentrations were measured at preoperative baseline (T<sub>0</sub>), 1 h (T<sub>3</sub>), 2 h (T<sub>4</sub>), 12 h (T<sub>5</sub>), and 24 h (T<sub>6</sub>) post-auto-transfusion. FHb and sCr levels were also assessed in the blood storage tank before washed (T<sub>1</sub>) and in the reinfusion bag after washing (T<sub>2</sub>).</p><p><strong>Results: </strong>In Groups A, B, and C, there was no significant change in sCr levels between T0 and subsequent time points (T<sub>3</sub>, T<sub>4</sub>, T<sub>5</sub>, T<sub>6</sub>). However, in Groups D and E, sCr levels increased by more than 26.5 μmol/L from baseline at T<sub>3</sub> and T<sub>4</sub>, with sustained elevations at T<sub>3</sub>, T<sub>4</sub>, and T<sub>5</sub> compared to T0. FHb concentrations were higher in both T<sub>1</sub> and T<sub>2</sub> compared to T<sub>0</sub>, following a similar trend as sCr. Patients receiving more than 600 mL of autologous transfusion showed a transient increase in sCr at 1 and 2 h post-transfusion, consistent with acute kidney injury (AKI), which resolved by 24 h after transfusion.</p><p><strong>Conclusion: </strong>Attention should be paid to renal function in patients receiving large volumes (>600 mL) of salvaged blood during intraoperative auto-transfusion, as these patients may experience transient AKI, which resolves over time.</p>\",\"PeriodicalId\":12477,\"journal\":{\"name\":\"Frontiers in Physiology\",\"volume\":\"16 \",\"pages\":\"1640701\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460466/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Physiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fphys.2025.1640701\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PHYSIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Physiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fphys.2025.1640701","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHYSIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨术中抢救性自体输血时输血负荷对肾功能的影响。方法：将200例患者按输血量分为5组：0 ~ 200 mL （A组，n = 40）、201 ~ 400 mL （B组，n = 40）、401 ~ 600 mL （C组，n = 40）、601 ~ 800 mL （D组，n = 40）、>800 mL （E组，n = 40）。在自体输血后的术前基线（T0）、1 h （T3）、2 h （T4）、12 h （T5）和24 h （T6）分别测定血清肌酐（sCr）和游离血红蛋白（FHb）浓度。同时检测洗前（T1）和洗后回输液袋（T2）中FHb和sCr水平。结果：A、B、C组患者T0及后续时间点（T3、T4、T5、T6） sCr水平无明显变化。然而，D组和E组在T3和T4时sCr水平比基线升高了26.5 μmol/L以上，在T3、T4和T5时与T0相比持续升高。与T0相比，T1和T2的FHb浓度均较高，趋势与sCr相似。接受超过600 mL自体输血的患者在输血后1和2小时出现短暂性sCr升高，与急性肾损伤（AKI）一致，并在输血后24小时消退。结论：术中自体输血大容量（bb0 ~ 600ml）回收血的患者应注意肾功能，因为这些患者可能出现一过性AKI，并随时间消退。
The effects of transfusion load on renal function in intraoperative salvage autotransfusion: a retrospective cohort study for 200 patients.
Objectives: This study aimed to investigate the effect of transfusion load on renal function during intraoperative salvage auto-transfusion.
Methods: A total of 200 patients were assigned to five groups based on the transfusion load: 0-200 mL (Group A, n = 40), 201-400 mL (Group B, n = 40), 401-600 mL (Group C, n = 40), 601-800 mL (Group D, n = 40), >800 mL (Group E, n = 40). Serum creatinine (sCr) and free hemoglobin (FHb) concentrations were measured at preoperative baseline (T0), 1 h (T3), 2 h (T4), 12 h (T5), and 24 h (T6) post-auto-transfusion. FHb and sCr levels were also assessed in the blood storage tank before washed (T1) and in the reinfusion bag after washing (T2).
Results: In Groups A, B, and C, there was no significant change in sCr levels between T0 and subsequent time points (T3, T4, T5, T6). However, in Groups D and E, sCr levels increased by more than 26.5 μmol/L from baseline at T3 and T4, with sustained elevations at T3, T4, and T5 compared to T0. FHb concentrations were higher in both T1 and T2 compared to T0, following a similar trend as sCr. Patients receiving more than 600 mL of autologous transfusion showed a transient increase in sCr at 1 and 2 h post-transfusion, consistent with acute kidney injury (AKI), which resolved by 24 h after transfusion.
Conclusion: Attention should be paid to renal function in patients receiving large volumes (>600 mL) of salvaged blood during intraoperative auto-transfusion, as these patients may experience transient AKI, which resolves over time.
期刊介绍：
Frontiers in Physiology is a leading journal in its field, publishing rigorously peer-reviewed research on the physiology of living systems, from the subcellular and molecular domains to the intact organism, and its interaction with the environment. Field Chief Editor George E. Billman at the Ohio State University Columbus is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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