Yoğun Bakımdaki COVID-19 Hastalarında Kan Transfüzyonu ve İlişkili Faktörlerin Analizi: Tek Merkez Örneği

Abstract

Amaç: Bu çalışmada COVID-19 Yoğun Bakım Ünitesi’nde (YBÜ) takip edilen hastalarda kan transfüzyonu karakteristiklerini, ilişkili faktörleri ve sonuçlarını tespit etmeyi amaçladık. Gereç ve Yöntemler: COVID-19 tanısıyla 21 Mart 2020 ve 01 Haziran 2020 tarihleri arasında COVID-19 YBÜ’nde takip edilen, 48 saatten uzun süre YBÜ’de kalan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, laboratuvar verileri (hemogram, koagülasyon parametreleri, inflamatuvar markerlar, arteriyel kan gazı parametreleri), kalp hızı, arteriyel kan basıncı, kanama bulguları, yaygın intravasküler koagülasyon (DIC) gelişimi, vazopressor ihtiyacı ve kan transfüzyonu ihtiyacı kaydedildi. Bulgular: Kan transfüzyonu uygulanan hastaların yoğun bakımda kalış süreleri [27 (4-65) gün], uygulanmayanlara göre [5 (0-30) gün] anlamlı şekilde yüksekti (p<0.001). Gruplar arasında yaş, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II (APACHE II) ve Glaskow koma skalası (GKS) skoru ortalamaları ile cinsiyet, Diabetes mellitus (DM), hipertansiyon, koroner arter hastalığı (KAH), kronik böbrek hastalığı (KBH) ve astım oranları açısından anlamlı bir fark saptanmadı (p>0.05). Kronik obstrüktif akciğer hastalığı (KOAH) oranlarının kan transfüzyonu uygulananlarda anlamlı şekilde yüksek olduğu (%33,3 vs %0,0) tespit edildi (p=0.026). Kan transfüzyonu uygulanan grupta fatalite hızı %44,4, transfüzyon uygulanmayan grupta fatalite hızı %21,1 saptandı (p=0.371). Sonuç: Çalışmamız sonucunda COVID-19 YBÜ’de KOAH tanısı olan, ağır kliniğe sahip olup entübasyon, mekanik ventilasyon gereken, uzun süre yoğun bakımda yatan hastalarda daha çok anemi geliştiği ve kan transfüzyonu yapıldığı, transfüzyon yapılan hastalarda ise mortalitenin yüksek olduğu tespit edilmiştir

Keywords

• COVID-19
• KAN TRANSFÜZYONU
• YOĞUN BAKIM ÜNİTESİ

Analysis of Blood Transfusion and Related Factors in COVID-19 Critical Care Patients: Single Center Example

Abstract

Aim: In this study, we aimed to determine the blood transfusion characteristics, related factors and results in patients followed in the COVID-19 Intensive Care Unit(ICU).Material and Methods: The files of patients who were followed up in the COVID-19 ICU between March 21, 2020 and June 01, 2020 with the diagnosis of COVID-19 and stayed in the ICU for more than 48 hours were retrospectively reviewed. Demographic data of the patients, laboratory data (hemogram, coagulation parameters, inflammatory markers, arterial blood gas parameters), heart rate, arterial blood pressure, bleeding findings, development of disseminated intravascular coagulation (DIC), vasopressor requirement and blood transfusion need were recorded. Results: The length of stay in the intensive care unit [27 (4-65) days] of the patients who received blood transfusion was significantly higher than those who did not [5 (0-30) days] (p<0.001). No significant difference was found between the groups in terms of age, Acute Physiology and Chronic Health Evaluation II(APACHE II) and Glasgow Coma Score (GCS) score averages, and gender, Diabetes mellitus (DM), hypertension, Coronary artery disease (CAD), chronic kidney disease (CKD) and asthma rates (p> 0.05). Chronic obstructive pulmonary disease (COPD) rates were significantly higher in those who received blood transfusion (33.3% vs 0.0%) (p=0.026). The fatality rate was 44.4% in the blood transfused group, and 21.1% in the non-transfused group (p=0.371). Conclusion: As a result of our study, it was determined that patients with a diagnosis of COPD in the COVID-19 ICU, who had a severe clinic and intubation need, mechanical ventilation, and who were hospitalized in the intensive care unit for a long time developed more anemia and blood transfusion, and mortality was higher in patients who underwent transfusion.

Keywords

• COVID-19
• intensive care unite
• blood transfusion

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