Prematüre anemisi olan çok düşük doğum ağırlıklı bebeklere eritrosit transfüzyonunun etkisi

Amaç: Bu çalışmada prematüre bebeklerde eritrosit transfüzyonunun (ET) klinik etkisinin araştırılması amaçlandı. Gereç ve Yöntemler: 2012-2018 yılları arasında yenidoğan yoğun bakım ünitesinde (YYBÜ) takip edilen ve gestasyonel haftası (GH)< 32 hafta ve/veya doğum ağırlığı (DA) < 1500 g olan çok düşük doğum ağırlıklı (ÇDDA) bebekler retrospektif olarak değerlendirildi. ET, Ohls 2007 ve Türk Neonatoloji Derneği Kan Ürünleri Transfüzyon Rehberi’ne göre yapıldı. Bulgular: 72 hasta çalışmaya dahil edildi. Ortalama DA 1325 g (680-2290 g), GH 30 hafta (25-32), ortanca postnatal yaş 36.7±26.9 gün (8-129), hastanede yatış sırasındaki ET sayısı 2±1.2 (1-6)’dı. ET öncesi ve sonrası ortalama kalp hızlarında (p=0.183) ve medyan solunum hızlarında (p=0.123) anlamlı bir değişiklik yoktu. Kilo alımı (16 g/gün-11 g/gün), ET’den önce ve sonra istatistiksel olarak benzerdi (p=0.861). ET sonrası apne, non-invaziv ventilasyon (NIV) ve kafein tedavisi gereksinimlerinde anlamlı azalma saptandı (p<0.001, p=0.016 ve p=0.016). Serum laktat (2.9-1.5) seviyeleri ET ile azaldı (p=0.017). Sonuç: Prematüre bebekler, YYBÜ’de kaldıkları süre boyunca anemi ve ilgili semptomlar açısından yakın takip edilmelidir. ET prematüre apne sıklığını, kafein tedavisi ve NIV gereksinimlerini azaltmaya yardımcı olabilir. ET anemili ÇDDA bebeklerde doku oksijenasyonunu düzeltir. ET kararı semptomların şiddetine göre verilmeli ve uluslararası, ulusal veya yerel transfüzyon rehberlerine göre yapılmalıdır.

Anahtar Kelimeler:

Anemi, Eritrosit Transfüzyonu, Prematüre

The Efficacy of Erythrocyte Transfusion in Very Low Birth Weight Infants with Premature Anemia

Objective: This study aimed to determine the clinical efficacy of erythrocyte transfusion (ET) in premature infants. Material and Methods: Very low birth weight (VLBW) infants with gestational age (GA) < 32 weeks and/or birth weight (BW) <1500 g and hospitalized in neonatal intensive care unit (NICU) between 2012-2018 were retrospectively evaluated. ET was performed according to Ohls 2007 and Turkish Neonatalogy Society Blood Products Transfusion Guidelines. Results: 72 infants included in this study. Mean BW was 1325 g (680-2290 g), GA was 30 weeks (25-32), median postnatal age was 36.7±26.9 days (8-129), number of ET during hospitalization was 2±1.2 (1-6). There were no significant changes in mean heart rates (p=0.183) and median respiratory rates before and after ET (p=0.123). Weight gain (16 g/day-11 g/day) was statistically similar before and after ET (p=0.861). A significant decrease in apnea, non-invasive ventilation (NIV) and caffeine therapy requirements after ET was determined (p<0.001, p=0.016 and p=0.016). Serum lactate (2.9-1.5) levels were decreased by ET (p=0.017). Conclusion: Premature infants should closely follow-up for anemia and related symptoms during NICU stay. ET may help to decrease frequency of apnea of prematurity, requirements of caffeine therapy and NIV. ET improves tissue oxygenation in VLBW infants with anemia. Decision of ET should be made according to severity of symptoms, and should be performed according to international, national or local transfusion guidelines.

Keywords:

Prematüre, Anemia, Erythrocyte transfusion,

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