Direkt coombs pozitif yenidoğanlarda light emitting diode fototerapinin etkinliği

Abstract

Amaç: Fototerapi, serum bilirubin düzeyleri fizyolojik sınırları aştığında en sık kullanılan tedavi yöntemidir. Direkt antiglobulin titresi (DAT) testi yenidoğanın immün hemolitik hastalığı tanısının temel taşı olarak kabul edilir.

Materyal ve Metot: Hastanemizde doğan ve gebelik yaşı 35 haftadan fazla olan hiperbilirubinemili hastalar çalışmaya alındı. DAT pozitif ve DAT negatif hastalar light emitting diode (LED) fototerapi etkinliği açısından karşılaştırıldı.

Bulgular: Yetmiş yedi olgu DAT negatif, 72 olgu DAT pozitif idi. DAT pozitif ve negatif gruplar arasında fototerapi ve hastanede yatış süresi açısından istatistiksel olarak anlamlı bir fark bulunmadı. DAT pozitif grupta hastaların fototerapi gereksinimlerinin daha erken bir aşamada (doğum sonrası yaş 1.4 gün, p <0.05) olduğu tespit edildi, exchange transfüzyon ve intravenöz immunoglobulin (IVIG) gerektiren hastaların oranı DAT pozitif bebeklerde istatistiksel olarak anlamlı derecede yüksekti.

Sonuç: LED fototerapi DAT pozitif hastalarda etkilidir ancak kan değişimi ihtiyacı ve IVIG bu hastalarda hala daha etkili fototerapiye ihtiyaç olduğunu göstermektedir.

Keywords

• Direkt antiglobulin,Hiperbilirubinemi,Yenidoğan,Fototerapi

Effectiveness of light emitting diode phototherapy for direct coombs positive newborns

Abstract

Background: Phototherapy is the most frequently used treatment when serum bilirubin levels exceed physiological limits. The direct antiglobulin titer (DAT) test is regarded as the cornerstone of diagnosis of immune hemolytic disease of the newborn.

Methods: Patients with hyperbilirubinemia who were born in our hospital and whose gestational age was over 35 weeks were enrolled. DAT positive and DAT negative patients were compared in terms of light emitting diode (LED) phototherapy efficacy.

Results: Seventy-seven cases were DAT-negative and 72 were DAT-positive. No statistically significant differences were found for the duration of phototherapy and hospitalization between the DAT-positive and negative groups. In the DAT-positive group, the phototherapy needs of the patients were determined to occur at an earlier stage (postnatal age 1.4 day, p<0.05), and the rate of patients requiring exchange transfusion, blood transfusion and intravenous immunoglobulin was found to be statistically significant higher in DAT-positive infants.

Conclusions: Although LED phototherapy is effective in DAT-positive patients, the need for  exchange transfusion and intravenöz immunoglobulin  (IVIG) shows that there is still a need for more effective phototherapy in these patients.

Keywords

• Direct antiglobulin,hyperbilirubinemia,newborn,phototherapy

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