Prematürede anemi ve transfüzyon politikaları

Yenidoğan döneminde anemi, fizyolojik olabildiği gibi prenatal, perinatal ve postnatal pek çok neden sonucu gelişebilmekte, ancak özellikle aşırı prematüre bebeklerde en önemli anemi nedenlerinden birisini iyatrojenik kan kayıpları oluşturmaktadır. Anemi saptanan bir yenidoğanda eritrosit transfüzyon kararı doku oksijenizasyonunu optimize edecek kan hemoglobin veya hematokrit düzeylerinin devamlılığının sağlanması amacıyla verilmektedir. Bunun için ise pratikte bebeğin kan hemoglobin ve/veya hematokrit düzeyi ve klinik durumu önem kazanmaktadır. Eritrosit transfüzyonunun pek çok potansiyel komplikasyonu da düşünüldüğünde prematüre bebeklere eritrosit transfüzyonu kararı verilirken kar-zarar oranı gözetilerek, güncel uygulamalar ışığında klinik bulguları eşliğinde bireyselleştirilmiş transfüzyon kararı verilmesi uygun gözükmektedir, ancak asıl amaç prematüre bebeklerde anemi gelişiminin önlenmesi olmalıdır. Bu derlemede prematüre anemisi, tanısı, transfüzyon tedavisi, komplikasyon ve korunma stratejileri son güncel uygulamalar ışığında verilmeye çalışılmıştır.

Anahtar Kelimeler:

Prematüre bebek, anemi, transfüzyon

Anemia and transfusion policies in premature infants

In the neonatal period, anemia may be physiological as well as many prenatal, perinatal and postnatal causes; however, especially in some extremely premature infants, one of the most important causes of anemia is iatrogenic blood losses. The decision of red blood cells transfusion in a newborn with anemia is made in order to maintain blood hemoglobin or hematocrit levels which will optimize tissue oxygenation. For that, the baby's blood hemoglobin and/or hematocrit level and clinical status are important practically. Considering the many potential complications of red blood cells transfusion, it seems appropriate to make an individualized transfusion decision in the light of current practices and clinical findings while deciding on transfuison of red blood cells for premature infants, however the main goal should be to prevent the development of anemia in premature infants.In this review, anemia of prematurity, diagnosis, transfusion therapy, complications and prevention strategies have been tried to be given in the light of recent current practices.

Keywords:

Preterm infant, anemia, transfusion,

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