Transfusion of Fresh Frozen Plasma and Platelets in Critically Ill Adults: An American College of Chest Physicians Clinical Practice Guideline.

Considering the variability in indications and thresholds guiding these transfusions, a comprehensive review of current evidence was conducted to provide guidance to critical care practitioners.

鉴于这些输血的指征和阈值存在差异，对当前证据进行了全面的审查，以向重症护理从业者提供指导。

This American College of Chest Physicians guideline examined the literature on platelet transfusions in critically ill patients with thrombocytopenia, with and without active bleeding, as well as data on prophylactic platelet and FFP transfusions for common procedures in the critical care setting.

这份美国胸科医师学院的指南审查了关于血小板输注在重症血小板减少症患者中的文献，无论是否伴有活动性出血，以及关于重症监护环境中常见程序的预防性血小板和新鲜冰冻血浆输注的数据。

Methods

A panel of experts developed 7 Population, Intervention, Comparator, and Outcome questions addressing platelet and FFP transfusions in critically ill patients and performed a comprehensive evidence review.

一组专家制定了7个关于血小板和新鲜冰冻血浆输注在重症患者中的问题，并对这些问题进行了全面的证据审查。

The panel applied the Grading of Recommendations, Assessment, Development, and Evaluations approach to assess the certainty of evidence, and to formulate and grade recommendations.

该小组应用了推荐、评估、发展和评估方法来评估证据的确定性，并制定和分级推荐意见。

A modified Delphi technique was used to reach consensus on the recommendations.

使用了改良的德尔菲技术来达成关于推荐意见的共识。

Results

The initial search identified a total of 7,172 studies, and after the initial screening, 100 articles were reviewed.

初步检索共识别出7,172项研究，经过初步筛选后，审查了100篇文章。

Sixteen studies met inclusion criteria, comprising 1 randomized controlled trialand 15 observational studies.

共有16项研究符合纳入标准，包括1项随机对照试验和15项观察性研究。

Overall, the certainty of the evidence for all questions was very low.

总体而言，所有问题的证据确定性非常低。

The panel formulated 7 conditional recommendations.

专家组制定了7条有条件推荐。

Conclusions

In critically ill patients with thrombocytopenia or coagulopathy, a risk/benefit assessment should be made by providers prior to transfusion of platelets or FFP.

对于血小板减少或凝血功能障碍的危重病患者，在输注血小板或新鲜冰冻血浆之前，提供者应进行风险/效益评估。

Given the known risks of blood product transfusion, and the limited data regarding the benefits from platelet or FFP transfusion, most patients will benefit from avoiding transfusion of these blood products.

鉴于已知的血液制品输注风险，以及关于血小板或新鲜冰冻血浆输注益处的有限数据，大多数患者将从避免输注这些血液制品中受益。

In patients at high risk of bleeding, or where the bleeding complication may be catastrophic, transfusion should be considered.

对于有高出血风险的患者，或者出血并发症可能导致灾难性后果的情况下，应考虑输血。