Yenidoğan Yoğun Bakım Ünitesinde Yapılan Kan Transfüzyonu Uygulamalarının Değerlendirilmesi; Tek Merkez Deneyimi

GİRİŞ: Yenidoğan bebeklerde kan transfüzyonu, diğer yaş gruplarındaki hastalara göre daha yüksek komplikasyon riskine sahip olup, bu yaş grubundaki transfüzyonlarda göz önünde bulundurulması gereken konular bulunmaktadır. Bu çalışmada, yenidoğan yoğun bakım ünitesi (YYBÜ)’nde kan transfüzyonu yapılmış bebeklerin kayıtlarının geriye dönük incelenmesiyle, transfüzyon yapılan tanı grupları, kullanılan kan ürünlerinin özellikleri ve transfüzyon uygulamaları güncelliğinin araştırılması hedeflendi. GEREÇ ve YÖNTEM: Başkent Üniversitesi Tıp Fakültesi İstanbul Hastanesi YYBÜ’sinde Kasım 2013 – Mayıs 2018 tarihleri arasında yatan 968 yenidoğan bebek arasından, 1377 transfüzyon uygulanan toplam 256 bebeğin dosya kayıtları geriye dönük incelendi. BULGULAR: Bebeklerin %43.8’i kız, ortanca doğum ağırlığı 2598 (1478 – 3228) gram, ortanca doğum haftası 36.5 (30 – 39) hafta, ortanca yatış süreleri 32 (15 – 67.5) gün bulundu. En çok kullanılan kan grubu A Rh (+), en az kullanılan kan grubu AB Rh (-)’ti. Transfüzyonların %39.9’u taze donmuş plazma, %36.2’si eritrosit, %23.5’i trombosit süspansiyonu ile yapılmıştı. En çok transfüzyon uygulanan tanılar sırasıyla prematürite ve ilişkili olduğu hastalıklar, santral sinir sistemi, konjenital kalp, gastrointestinal sistem hastalıkları ile ilişkili cerrahi girişim gerektiren hastalıklardı. Term bebeklere göre, preterm bebeklerde trombosit süspansiyonu kullanım oranı daha yüksekti, diğer ürünlerin kullanım oranı benzerdi. SONUÇ: YYBÜ’lerde çok sık yapılan kan transfüzyonu uygulamalarıyla ilgili hekimlerin bilgilerini güncellemeleri ve transfüzyon tıbbı konusunda verilen eğitimlerin yaygınlaşması, transfüzyonda kullanılacak kan ürününün doğru seçilmesini ve hazırlanmasını, transfüzyon risklerinin azaltılmasını, gereksiz transfüzyonların önünde geçilmesini sağlayacak ve transfüzyon güvenliğini arttıracaktır.

Anahtar Kelimeler:

Kan transfüzyonu, transfüzyon güvenliği, prematürite, yenidoğan

Evaluation of Blood Transfusion Applications in Newborn Intensive Care Unit; Single Center Experience

INTRODUCTION: The frequency of transfusion is high in infants admitted to neonatal intensive care unit (NICU). There is a higher risk of transfusion complications compared to other age groups, and there are many special considerations for transfusion in neonates. The aim of this study was to investigate the records of infants who had blood product transfusions in NICU, to investigate which patient groups were transfused, the characteristics of the blood products used and the current transfusion practices. MATERIALS and METHODS: Between November 2013 and May 2018, the records of 968 newborn infants admitted to the Istanbul Hospital NICU of Başkent University School of Medicine were retrospectively analyzed. RESULTS: Of the babies, 43.8% were female, median birth weight was 2598 (1478 - 3228) grams, median birth week was 36.5 (30 - 39) weeks and median hospitalization days were 32 (15 - 67.5) days. The most commonly used blood group was A Rh (+), the least used blood group AB Rh (-). 39.9% of the transfusions were fresh frozen plasma, 36.2% erythrocyte and 23.5% platelet suspension. In addition to prematurity and related diseases, diseases requiring surgery of central nervous system, congenital heart or gastrointestinal system diseases were the most common transfused group. According to term babies, the rate of use of thrombocyte suspension was higher in preterm infants, however the rate of use of other products was similar. CONCLUSIONS: Knowledge of the selection, preparation of blood products to be used in transfusion and the specific methods for reducing the risks of transfusion will reduce the potential risks and increase the safety of transfusion.

Keywords:

Blood transfusion packed red blood cell unit, newborn, prematurity, transfusion safety,

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