Elif ÖZALKAYA, Sevilay TOPÇUOĞLU, Güner KARATEKİN, Fahri OVALI, Tuğba GÜRSOY, Egemen YILDIRIM

Yenidoğan polisitemisinde kısmi kan değişimi

Amaç: Polisitemik zamanında doğmuş ve geç prematür hastalarda kısmi kan değişiminin kısa dönem etkilerini değerlendirmektir. Gereç ve Yöntem: Zeynep Kamil Kadın ve Çocuk Hastalıkları Hastanesi Yenidoğan Yoğun Bakım Birimine Ocak 2009 ile Mayıs 2010 tarihleri arasında yatırılan polisitemik geç prematür ve zamanında yenidoğanlar geriye dönük olarak değerlendirildi. Bulgular: Çalışma süresince doğan 16 bin bebekten, 163’ü polisitemi nedeni ile hastaneye yatırıldı. Polisitemi sıklığı %1’idi. Geç prematür polisitemik hastalar (n=68/163;%41,7): bulgu veren (n=23/163;%14,1) ve bulgu vermeyen (n=45/163;%27,6); zamanında doğmuş polisitemik (n=95/163; %58,3) hastalar: bulgu veren (n=21/163;%12,9), bulgu vermeyen (n=74/163;%45,4) olmak üzere iki gruba ayrıldı. Kısmi kan değişimi 102 olguya uygulandı. Kısmi kan değişimi yapılan hastalar; bulgu veren geç prematür 18/102 (%17,7), bulgu vermeyen geç prematür 23/102 (%22,6), bulgu veren zamanında doğmuş bebek 14/102 (%13,7), bulgu vermeyen zamanında doğmuş bebek 47/102 (%46) olarak gruplandırıldı. Medikal tedavi 61 hastaya uygulanmıştı. Medikal tedavi yapılan hastaların gruplara göre dağılımı; bulgu veren geç prematür 5/61 (%8,2), bulgu vermeyen geç prematür 22/61 (36%), bulgu veren zamanında doğmuş bebek 7/61(%11,5), bulgu vermeyen zamanında doğmuş bebek 27/61(%44,3) bulundu. Kısmi kan değişimi sonrası, zamanında doğmuş hastalarda hastanede kalış süresinin, zamanında doğmuş bulgu vermeyen hastalarda tam enteral beslenmeye geçiş süresinin kan değişimi uygulanmayan hastalara göre anlamlı olarak daha uzun olduğu gösterildi ( p

Partial exchange transfusion for neonatal polycythemia

Aim: The aim of this study was to investigate the short term effects of partial exchange transfusion on the morbidity of preterm and term polycythemic neonates. Material and Method: Late preterm and term infants with polycythemia hospitalized in Zeynep Kamil Maternity and Children’s Training Hospital Neonatal Intensive Care Unit from January 2009 to May 2010 were evaluated retrospectively. Results: One hundred-sixty-three of 16.000 infants who were born during the study period were hospitalized with a diagnosis of polycythemia. The incidence of polycythemia was 1%. Late preterm polycythemic (n=68/163; 41.7%) patients were divided into two groups as symptomatic (n=23/163; 14.1%) and asymptomatic (n=45/163; 27.6%) infants. Term polycythemic (n=95/163; 58.3%) patients were divided into two groups as symptomatic (n=21/163; 12.9%) and asymptomatic (n=74/163; 45.4%) infants. Partial exchange transfusion was performed in 102 patients. Of these infants, 18/102 (17.7%) were symptomatic late preterm, 23/102 (22.6%) were asymptomatic late preterm, 14/102 (13.7%) were symptomatic term and 47/102 (46%) were asymptomatic term infants. The number of the patients who were treated medically (hydration) was 61. Of these patients 5/61 (8.2%) were symptomatic late preterm, 22/61 (36 %) were asymptomatic late preterm, 7/61 (11.5%) were symptomatic term and 27/61 (44.3%) were asymptomatic term patients. Duration of hospitalization in the term symptomatic group and time to reach full enteral feeding in the asymptomatic term group were longer in patients in whom partial exchange transfusion was performed (p

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