Yenidoğan Ünitesinde İndirekt Hiperbilirubinemi Nedeniyle Yatan Hastalarda Olası Risk Faktörlerinin Araştırılması

Year 2017, Volume: 3 Issue: 3, 171 - 176, 01.01.2017

Selma Aktaş Serpil Ece Aras Öztürk Seda Geylani Güleç

Abstract

Amaç: Çalışmanın amacı, indirekt hiperbilirubinemi nedeniyle yenidoğan yoğun bakım ünitesine yatan hastalarda indirekt hiperbilirubinemi gelişimi için risk faktörü olabilecek durumları belirlemektir.Gereç ve Yöntemler: Çalışmada yenidoğan yoğun bakım ünitesine yatırılarak tedavi edilen indirekt hiperbilirubinemili 250 term ve geç-preterm bebek retrospektif olarak değerlendirildi. Hastalara ait veriler hasta dosyaları taranarak elde edildi ve hazırlanan olgu rapor formlarına kaydedildi.Bulgular: Çalışma grubundaki olguların % 42’i kız, % 58’i erkekti. Gebelik haftaları ortalama 38,6 ±1,3 ve doğum tartısı 3158±463 gr olarak saptandı. % 36,8’i sezaryen ile % 63,2’i normal spontan vajinal yolla doğmuştu. Hastaların %58,4’ü sadece anne sütü ile, % 41,6’ı anne sütü ve formül mama ile beslenmekteydi. Yatış sırasındaki tartı kaybı ortancası % 4 min 0, max 20 idi, tartı kaybı yüzdesi ≥%10 olan olguların oranı ise % 6.4 idi ve bu olguların yarısından fazlası ilk bebekti. Hastaneye yatış yaşı ortalama 4,2±2,3 gündü, ortalama yatış total bilirubin düzeyi 17±3,78 mg/dl ve bu hastalara uygulanan fototerapi süresi ortalama 28,7±10,8 saat idi. Hastaların % 5,2’de Rh uygunsuzluğu, % 29,6’da ABO uygunsuzluğu tespit edildi. Yatırılıp tedavi edilen hastaların % 43,2’nin yatış sırasındaki TSB düzeylerinin Amerikan Pediatri Akademisi kılavuzlarında önerilen fototerapi sınırının altında olduğu saptandı.Sonuç: Çalışma grubumuzda indirekt hiperbilirubinemi erkeklerde daha sıktı. Beklenenin aksine gestasyon yaşı ve doğum şeklinden etkilenmediği görüldü. Hekim kaynaklı kaygılar nedeni ile bebeklerin neredeyse yarısının daha düşük bilirubin düzeyi ile tedavi edildiği tespit edildi

Keywords

İndirekt hiperbilirubinemi, Risk faktörleri, Yenidoğan, Tedavi

Investigation of the Potential Risk Factors of Indirect Hyperbilirubinemia in Patients Admitted to the Neonatal Intensive Care Unit with Hyperbilirubinemia

Abstract

Objective: The aim of this study was to determine the risk factors for indirect hyperbilirubinemia in patients admitted to the neonatal intensive care unit NICU for the treatment of jaundice.Material and Methods: A total of 250 term and late preterm neonates who were treated with the diagnosis of indirect hyperbilirubinemia were evaluated retrospectively. The related data were obtained by screening the files of patients and recorded in the prepared case report form.Results: Forty-two percent of the patients were female. The mean gestational age and birth weight were 38.6 ±1.3 weeks and 3158±463 gr, respectively. Out of the 250, 36.8 %were born by caesarean section, 58.4% were breast-fed and 41.6% were fed both human milk and formula. The median percentage of weight loss during admission to NICU was 4% 0-20% . The percentage who lost ≥10% of their weight was 6.4% and more than 50% of these patients were firstborn. The mean age of hospital admission was 4.2±2.3 days, total bilirubin level was 17±3.78 mg/dl and phototherapy duration was 28.7±10.8 hours. Rh incompatibility was detected in 5.2% and ABO incompatibility in 29.6 % of the patients. The total serum bilirubin level of 43.2% of patients admitted to and treated in the NICU was below the recommended treatment levels of the American Academy of Pediatrics. Conclusion: In the study group, indirect hyperbilirubinemia was more frequent among males, Contrary to expectations, jaundice was not affected by gestational age or the type of delivery. Because of the anxiety of clinicians, nearly half of the babies were treated with bilirubin levels lower than the phototherapy levels of guidelines

Keywords

Indirect hyperbilirubinemia, Risk factors, Neonate, Treatment

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