Yenidoğanlarda hipoksik iskemik ansefalopati evresi ile eritropoietin düzeyleri arasındaki ilişki: Tedavide kullanılabilir mi? Özgün Araştırma

Özet Amaç: Yenidoğan hipoksik iskemik ansefalopatisi ciddi bir hastalığa ve ölüme sebep olmasına rağmen günümüzde etkin bir tedavisi yoktur Eritropoietin hipoksik iskemik beyin zedelenmesinden sonra işlevsel olarak iyileşme sağladığı gösterilmesine rağmen uygulama zamanı ve uygun doz uygulaması tam olarak ortaya çıkarılamamıştır Bu çalışmanın amacı asfiktik yenidoğanlarda hipoksinin şiddeti ve serum eritropoietin seviyesini karşılaştırmak ve bu ilişkinin klinik kullanım açısından önemini değerlendirmektir nbsp; Gereç ve Yöntem: Eritropoietin düzeylerini doğum sonrası 0 12 24 36 ve 48 saatlerde enzim immün yöntemi ile dört grupta ölçtük Bu gruplar 1 evre 1 n=11 ; 2 evre 2 n=9 ; 3 evre 3 hipoksik iskemik ansefalopatisi olan yenidoğanlar n=8 ve sağlıklı kontrol grubundan n=10 oluşmakta idi Bulgular: Kontrol grubunda eritropoietin düzeyinin geometrik ortalaması 5 mU mL idi Eritropoietin seviyeleri 0 ve 12 saatte grup 2 ve 3 rsquo;de kontrol ve grup 1 rsquo;e göre; 24 ve 36 saatlerde ise grup 3 rsquo;de diğer gruplara göre istatistiksel olarak anlamlı derecede yüksekti p=0 01 Kontrol ve hipoksik iskemik ansefalopati gruplarında 48 saatte fark yoktu p gt;0 05 Çıkarımlar: Bu sonuçlara göre zamanında doğan yenidoğanlarda rekombinan insan eritropoietin tedavisinin orta derece hipoksik iskemik ansefalopatide 12 saat ağır olgularda 24 saat sonra kullanılması gerektiğini düşünmekteyiz Türk Ped Arş 2010; 45: 334 8 Anahtar sözcükler: Eritropoietin hipoksik iskemik ansefalopati yenidoğan

Anahtar Kelimeler:

Eritropoietin, hipoksik-iskemik ansefalopati, yenidoğan

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Malpractice has gained an alarming dimension especially along with the introduction of compulsory professional liability insurance On the other hand it is quite difficult to say that malpractice is discussed by considering all responsible determinants According to individual focused approach the error is caused by single individual so the solution can be achieved by punishing the individual It is known that this approach does not reduce errors and adversely affect services due to high compensations and increased insurance premiums In Turkey malpractice is simply considered in the customer seller relationship context and individual focused approach is adopted However it is well established that this ldquo;blame culture rdquo; has negative effects on service provided social perception of the profession and job satisfaction Beside recognizing individual professional responsibilities basically it should be stressed that declaring healthcare workers as mainly responsible would not be fair In addition it violates right to health because of increasing the preventable errors and harms Turk Arch Ped 2011; 46: 6 11

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