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1
2
3 ABO 15 RhoD T&S 24 MSBOS 24 SBOE
4
5
6
7 GVHDTRALI Yersinia enterocolitica HIV B
8 NAT
9 1 2 3
10
11 MAP 2 3
12 HIV
13
14
15 ABORhoD HBsHBsHBc HCV HIV HTLV HBV HCVHIVNAT ALTGPT B B 1 2 GyGy
16 1 ABOAB AB AB AB 2 3 DRhoD
17 D AB ABORhoD ABORhoD 1 ABORhoD
18 2 1 ABO 2 ABO ABO RhoDABORho D 3 ABO 4 ABORhoD ABO
19 5 ABO OA B 6 O ABO
20 1 ABORhoD ABO 2 ABO O OABO 3 RhoDRhoD RhoDABO RhoD RhoD D D RhoD. 4 O RhoDRhoD
21 1 ABO ABO RhoD 2 ABO 3 O
22 ABO O A O B O AB OAB O 1 ABO 2 AB ABO ABORhoDRhoD
23 3 ABO RhoD RhoD RhoD DD 1 2 1
24 2 3 4
25 T&S MSBOS ABORhoD RhoD ABO TCC/T.
26 HbHbHb g/dl Hb Hb.T&S. 1
27 2 3 Yersinia enterocolitica 4
28 5 6 7 ID 8 PDA 9
29 10 SpO 1 ABO 2 1
30 2 TRALI ml ml
31 1 1 ABO
32 2 Delayed Hemolytic Transfusion Reaction ; DHTR 2 1 TRALI
33 Yersinia enterocolitica TRALI TRALI TRALI
34 volume overload TRALI TRALI HLA 2
35 B HBs HBs HBc NAT C HCV HCV HCV HIV HIV T THTLV
36
37 1 2 3
38 kg kgml Yersinia enterocolitica
39 VVR 1 2 3
40
41
42
43 X
44 1
45
46
47
48
49 .. / /
50
51 1 / Hbg/dL Hbg/dL B Hbg/dL 2 Hbg/dL g/dl Hb
52 3 1 /Hb g/dlht 2 HES,mL ml/ Hbg/dL Hb g/dl 3
53 Hb Hbg/dLHbg/dL ml/kg dlkgml/kg/ kgdlhb g/dlml LRmL Hbg/dL/dL ghb.g/dl
54 /L /L /L /L /L 1 /L 2 /L
55 /L 3 /L /L oozing /L 4 5 DIC /L DIC
56 6 1 /L /L 2 /L /L /L 3 ITP ITP ITP NAIT PTP
57 /L /L 8 /L /L
58 /L ml ml/kg.,mlkg,/l kg
59 PT APTT 1 1/PT INR.APTT PTINR. L DICPTAPTT mg/dl DIC
60 PTINR.K 2100/ DIC L 2 CS 3 TTPTTP
61 TTP HUS ml/kgml/kght/ ml/kgml/kg DIC
62 1.g/dL,mL 2 kg
63 3 L
64 .g/dl 8 9 g g/dldl..dl/kg/ 1 2 3
65
66
67 1,mL
68 2
69 3 HES TTP/HUS
70 4 LL 5
71 Red Cell Concentrate ; RCC 1 B
72 Hb Hbg/dL Hbg/dL Hb / Hbg/dL Hb iron overload
73 Hb g/dl 2 Hb class class class class Hbg/dL g/dl
74 Hbg/dL Hb 3 1 /Hb g/dlht Ht
75 2 HES ml/kg ml/kg
76 ,ml ml/
77 mmhgmmhg.ml/kg/ Hbg/dL Hbg/dL 3 Hb Hbg/dLHbg/dL ml/kg dlkgml/kg/ kg dlhb
78 g/dlmllr mlhb g/dl/dlg Hb.g/dL 1 2 1
79 Yersinia enterocolitica 2 mlmg mg Hbg mg Hb 3 Gy ml meq
80 4 5 ABO ID American College of Surgeons : Advanced Trauma Life Support Course Manual. American College of Surgeons. ; American Society of Anesthesiologists Task Force : Practice guideline for blood component therapy. Anesthesiology. ; : LundsgaardHansen P, et al : Component therapy of surgical hemorrhage : Red cell concentrates, colloids and crystalloids. Bibl. Haematol. ; : GVHD GVHD
81 Platelet Concentrate ; PC 13 /L /L /L
82 /L /L f. /L /L /L /L /L
83 /L /L /L oozing /L/L
84 DIC /L DIC DIC DIC DIC 1 /L /L /L HLA DIC /L
85 2 /L /L /L 3 Idiopathic Thrombocytopenic Purpura ; ITP ITP ITP Neonatal Alloimmune Thrombocytopenia ; NAIT
86 Posttransfusion Purpura ; PTP 4 TTPHUS 5 6 /L
87 /L /L /L / L DIC HLA
88 HLAHLA HLA HLA HLA HLA HLA HLA /L /L ml / ml/kg
89 .,mlkg,/l kg corrected count increment ; CCICCI CCI/L / CCI,/L CCI,/L
90 PTGVHD Gy 5 CMV
91 CMV CMV CMV CMV 6 7 ABO RhRh Rh RhRHIG D HLA HLA ABO 8 ABOABO AB
92 AB ABO British Committee for Standards in Haematology, Blood Transfusion Task Force : Guidelines for the use of platelet transfusions. Br. J. Haematol. ; : Schiffer CA, et al : Clinical Practice Guidelines of the American Society of Clinical Oncology. J. Clin. Oncol. ; : A Report by the American Society of Anesthesiologists Task Force on Blood Component Therapy : Practice Guidelines for Blood Component Therapy. Anesthesiology. ; : Wandt H, et al : Safety and cost effectiveness of a / L trigger for prophylactic platelet transfusions compared with the traditional / L trigger : a prospective comparative trial in patients with acute myeloid leukemia. Blood. ; : Rebulla P, et al : The threshold for prophylactic platelet transfusions in adults with acute myeloid leukemia. Gruppo Italiano Malattie Ematologiche Mallgne dell'adulto. N. Engl. J. Med. ; : Heckman KD, et al : Randomized study of prophylactic platelet transfusion threshold during Induction therapy for adult acute leukemia :, / microl versus, / microl. J. Clin. Oncol. ; :
93 Fresh Frozen Plasma ; FFP PTAPTT DIC
94 1 1 PTINR.APTT PTAPTT./ PTINR. L
95 L DICDIC CS PTAPTT mg/dl DIC mg/dl PTAPTT
96 A B PTINR. K K
97 2100/ PTAPTT DICDIC LL 2 CS CS C C 3 TTP unusually large ULvWFM ULvWFM
98 vwf ADAMTS TTP./ ULvWFMvWF TTP OH HUS ml/kgml/kght/ ml/kgml/kg kgml LR.mLFFPLRmL mlffplrml ml FFPLR mlffplr
99 ml Ht
100
101 5 DIC LR
102 CPD.mLFFPLR mlmlffplrml ml.gmeqml FFPLR.gmEq Na ACDAmL.gmEqNa CPDACDA 5 6
103 PTAPTT /LPTINR. APTT mg/dl DDAVP Atype
104 VWFADAMTS TTP/HUS Mori Y, et al : Predicting response to plasma exchange in patients with thrombotic thrombocytopenic purpura with measurement of vwfcleaving protease activity. Transfusion. ; : AABB : Blood Transfusion Therapy ; A Physicians Handbook th ed.,, p.
105 1. g/dl,ml
106 2 Alb kg 3 L Runyon BA : Management of adult patients with ascites due to cirrhosis. Hepatology ; : 4
107 5 6
108 . 7.g/dL 8 9
109 g g/dldl..dl/kg/ kg.g/dl.g/dl.dl/kgkg...g g/dlkg g kgg /g/dl g./.dl/kgkg/g/dl.g/dl. g/dl
110 g/dL 4
111 1.mg/mLmEq/L 2 ml gml 3 ml/ 4 5 g/dl ph TP
112 Cg/dL.C.C.C Cg/dL.C.C.C Alb.g/dL......mmHg TP.g/dL......mmHg 1
113 1 1 Hbg/dL Hbg/dL MAPMAP RCC 2 ml/kgml/kg/
114 ml/kg/ 3 1 MAP MAP G MAP LR LR 2 3
115 Gy 1 /L /L /L /L 1 1 KPT APTT 2/ 3
116 2 ml/kg ml/kg 3
117 1 Hb Hb g/dl RCC Hb RCC cytomegalovirus ; CMV CMV CMV CMV MAP LRLR
118 2 PC /L /L HLA
119 matchmajor mismatchminor mismatchmajor and minor mismatch
120 ABO ABOAB O RhoDRho DRhoD RhoD RhoDRhoD
121 ABORhoD
122 SBOE HbHbg/dL Hb ml ml/kgml.g/dl HbHt HbHt
123 offpump Hb Hbg/dLg/dL sequestration A
124 /L TEG
125 Hb.g/dL Hb HbHb g/dl g/dl
126 INR mosm/l
127 mosm/l Ht //
128 .ml/ kg/min MAP ABOABO
129 ABO 10 g/dl 11 Ht DPG MAPDPG
130 DPG 12 Ht Ht Ht critical oxygen deliverydo crit DO crit ml/min,mlht HtHt Ht Ht
131 Hbg/dLHt HtHb..g/dL Hb..g/dL ASA Hbg/dL 13
132 14 PTINR. TTP HUSTTP von Willebrand Factor von Willebrand Factor Cleaving ProteasevWFCPADAMTS
133 vwfcp vwfcp vwfcp BCSH.Guideline Guidelines on the Diagnosis and Management of the Thrombotic Microangiopathic Haemolytic Anemias. British Journal of Haematology ; : 15 CPD citratephosphatedextrose.g/l.g/l.g/l.g/l ACDAacidcitrate dextrose.g/l.g/l.g/l CPD MAPmannitol adeninephosphated.g/l.g/l.g/l.g/l.g/l.g/l.g/l MAPMAPRCC MAP MAPMAP MAPLR
134 LR LRCPD mlmlmlml MAPmL mlcpd LR LRLR ml RCCLR ml mlrcclrml mlht Hbg/dL LRLR LRLR MAPMA P
135
136
137 16. HLA
138
139 17 LR CPDmLmL mlml mlffplr mlffplr ACDA ml FFP LR ml
140 Quarantine NAT
141
142 18 1.w/v HBVHCV HIV AHAVE HEV 2, g ml g.g/kg.g/kg/
143 Vamvakas EC : Is white blood cell reductionequivalent to a n t i body screening i n p r eve n t i n g t r a nsmission of Cytomegalovirus by transfusion? A review of the literature and metaanalysis. Transfus. Med. Rev. ; : Stover EP, et al : Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines. Anesthesiology. ; : Hessel EA, et al : Platelet kinetics during deep hypothermia. J. Surg. Res. ; : Valeri CR, et al : Hypothermiainduced reversible platelet dysfunction. Ann. Surg. ; : Michelson AD, et al : Reversible inhibition of human platelet activation by hypothermia in vivo and in vitro. Thromb. haemost. ; : Boldt J, et al : Normothermic versus hypothermic cardiopulmonary bypass : do changes in coagulation differ? Ann. Thorac. Surg. ; : Nuttall GA, et al : Efficacy of a simple intraoperative transfusion algorithm for nonerythrocyte component utilization after cardiopulmonary bypass. Anesthesiology. ; : Karski JM, et al : Etiology of preoperative anemia in patients undergoing scheduled cardiac surgery. Can. J. Anaesth. ; : Williams GD, et al : Factors associated with blood loss and blood product transfusions : A multivariate analysis in children
144 after openheart surgery. Anesth. Analg. ; : ShoreLesserson, et al : Thromboelastographyguided transfusion algorithm reduces transfusions in complex cardiac surgery. Anesth. Analg. ; : Dougenis D, et al : Blood use in lung resection for carcinoma : perioperative elective anaemia does not compromise the early outcome. Eur. J. Cardiothorac. Surg. ; : Motoyama S, et al : Use of autologous instead of allogeneic blood transfusion during esophagectomy prolongs diseasefree survival among patients with recurrent esophageal cancer. J. Surg. Oncol. ; : Kinoshita Y, et al : Usefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection. Surgery. ; : Takemura M, et al : Immunologic effects of allogeneic versus autologous blood transfusion in patients undergoing radical oesophagectomy. Eur. Surg. Res. ; : Dresner SM, et al : Prognostic significance of perioperative blood transfusion following radical resection for oesophageal carcinoma. Eur. J. Surg. Oncol. ; : Schmied H, et al : The effects of redcell scavenging, hemodilution, and active warming on allogenic blood requirements in patients undergoing hip or knee arthroplasty. Anesth. Analg. ; : McSwiney MM, et al : Blood transfusion in total hip arthroplasty : guidelines to eliminate overtransfusion. Can. J. Anaesth. ; : : Olfsger D, et al : Acute normovolemic haemodilution decreases postoperative allogenic blood transfusion after total knee replacement. Br. J. Anaesth. ; : : Thomas D, et al : Autologous blood transfusion in total knee
145 replacement surgery. Br. J. Anaesth. ; : Neilipovitz DT, et al : A Randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesth. Analg. ; : Shmied H, et al : Mild hypothermia increases blood loss and transfusion requirements during total hip arhtroplasty. Lancet. ; : Monk TG, et al : Acute normovolemic hemodilution can replace preoperative autologous blood donation as a standard of care for autologous blood procurement in radical prostatectomy. Anesth. Analg. ; : Bryson GL, et al : Does acute normovolemic hemodilution reduce perioperative allogeneic transfusion? A metaanalysis. Anesth. Analg. ; : Hogue CW Jr, et al : Perioperative myocardial ischemic episodes are related to hematocrit level in patients undergoing radical prostatectomy. Transfusion. ; : Linko K, et al : Electrolyte and acidbase disturbances caused by blood transfusion. Acta. Anaesthesiol. Scand. ; : Brown KA, et al : Hyperkalemia during rapid blood transfusion and hypovolaemic cardiac arrest in children. Can. J. Anaesth. ; : Jameson LC, et al : Hyperkalemic death during use of a high capacity fluid warmer for massive transfusion. Anesthesiology. ; : Rock G, et al : Effect of citrate anticoagulations on factor levels in plasma. Transfusion. ; : Murray DJ, et al : Coagulation changes during packed red cell replacement of major blood loss. Anesthesiology. ; Consensus Conference : Fresh frozen plasma. Indications and
146 risks. JAMA. ; : Harke H, et al : Haemostatic disorders in massive transfusion. Bibl. Haematol. ; : Ferrara A, et al : Hypothermia and acidosis worsen coagulopathy in the patient requiring multiple transfusion. Am. J. Surg. ; : SunderPlessman L, et al : Acute normovolemic hemodilution : change in tissue oxygen supply and hemoglobinoxygen affinity. Bibl. Haematol. ; : Shah DM, et al : Failure of red blood cell transfusion to increase oxygen transport or mixed venous PO in injured patients. J. Trauma. ; : Rosberg B, et al : Hemodynamics following normovolemic hemodilution in elderly patients. Acta. Anaesthesiol. Scand. ; : VaraThorbeck R, et al : Hemodynamic response of elderly patients undergoing major surgery under moderate normovolemic hemodilution. Eur. Surg. Res. ; : Messmer K : Hemodilution. Surg. Clin. North. Am. ; : Shibutani K, et al : Critical levels of oxygen delivery in anesthetized man. Crit. Care. Med. ; : Carson JL, et al : Severity of anaemia and operative mortality and morbidity. Lancet. ; : Hogue CW Jr, et al : Perioperative myocardial ischemic episodes are related to hematocrit level inpatients undergoing radical prostatectomy. Transfusion. ; :. Rao SV, et al : Relationship of blood transfusion and clinical outcome in patients with acute coronary syndromes. JAMA. ; : Wu WC, et al : Blood transfusion in elderly patients with acute
147 myocardial infarction. N. Engl. J. Med. ; : Stehling L, et al : The red blood cell transfusion trigger. Arch. Pathol. lab. Med. ; : Spence RK : Emerging trends in surgical blood transfusion. Semin. Hematol. ; : Task force on blood component therapy : Practice guidelines for blood component therapy. A report by the American Society of Anesthesiologists task force on blood component therapy. Anesthesiology. ; : College of American Pathologists : Practice parameter for the use of freshfrozen plasma, cryoprecipitate, and platelets. JAMA. ; : Simon A, et al : Practice parameter for the use of red blood cell transfusions. Arch. Pathol. Lab. Med. ; : American Society of Anesthesiologists Task Force on Blood Component Therapy : Practice guidelines for blood component therapy : A report by the American Society of Anesthesiologists Task Force on blood component therapy. Anesthesiology. ; : Nuttall GA, et al : Current transfusion practices of members of the American Society of Anesthesiologists : A survery. Anesthesiology. ; : MAP MAP Survival study
148
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150 15 50
151
152
153 17
154 17
155 19 26
156 mlml mlml mlml 19 26
157
158 21 20
159 . ml ml 21 20
160 GVHD 21 20
161 MEMO
162
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1) American College of Surgeons:Advanced Trauma Life Support Course Manual. American College of Surgeons 1997;103-112 24 2) American Society of Anesthesiologists Task Force:Practice guideline for blood
More information参考 18 アルブミンの製法と性状 1) 製法 製剤アルブミン製剤は, 多人数分の血漿をプールして, 冷エタノール法により分画された蛋白成分である 含有蛋白質の 96% 以上がアルブミンである製剤を人血清アルブミンといい, 等張 ( 正常血漿と膠質浸透圧が等しい ) の 5% 溶液と高張の 20,2
68 参考 18 アルブミンの製法と性状 1) 製法 製剤アルブミン製剤は, 多人数分の血漿をプールして, 冷エタノール法により分画された蛋白成分である 含有蛋白質の 96% 以上がアルブミンである製剤を人血清アルブミンといい, 等張 ( 正常血漿と膠質浸透圧が等しい ) の 5% 溶液と高張の 20,25% 溶液とがある また, 等張製剤にはアルブミン濃度が 4.4w/v% 以上で含有総蛋白質の
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新鮮凍結血漿の組成は, 採血時に混合した血液保存液 ( 全血液由来は ACD-A 液又は CPD 液, 成分採血由来は ACD-A 液を使用 ) により異なる ( 表 4) 含有成分は血液保存液により希釈されて, 単位容積当たりの濃度は正常血漿と比較して, およそ 10 15% 低下している 例えば, アルブミン濃度は約 4.0g/dL( 全量約 3g/ 単位 ) と低くなっている また, 血漿中の凝固因子活性の個人差は大きいが,
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