Evaluation of Erythrocyte Suspension Use in Neonates

Abstract

Objective: Erythrocyte suspension (ES) transfusion is frequently used in neonatal intensive care units (NICU). We evaluated the use of ES in hospitalized patients in the NICU of our hospital in terms of transfusion rate, indication, laboratory control, complications, and adherence to the guidelines. Material and Methods: Patients who were hospitalized at the University of Health Sciences of Turkey, Dr Sami Ulus Maternity and Children Research and Training Hospital, NICU, in 2016, and who received ES were included in this descriptive study.The demographic and clinical characteristics of the patients, the quantity of ES used, and the laboratory tests of the first three transfusions were recorded.The compliance of ES usage indications with the transfusion guidelines published in the Nelson Pediatric Textbook and the Turkish Neonatology (TND) Society Blood Products Transfusion Guidelines was assessed. Results: One hundred and ninety one of the 1538 admitted patients in the NICU received a total of 633 ES, for a 12.4% ES usage rate. Following an evaluation of the first three transfusions, it was determined that there was 66% compliance with the TND Blood Products Transfusion Guide and 64% compliance with the Nelson Pediatric Textbook transfusion protocol. It was significant that the frequency of retinopathy of prematurity (p=0.015) and intracranial hemorrhage (p=0.001) was high in premature infants who received more than one ES. Conclusion: Although transfusion is life-saving in crucial circumstances, there may be a cause-effect relationship between the detected morbidity and complications. Each newborn should be carefully evaluated individually and within the framework of the guidelines before having to decide on an erythrocyte transfusion.

Keywords

• Complication
• Erythrocyte transfusion
• Indication
• Newborn

Yenidoğanlarda Eritrosit Süspansiyonu Kullanımının Değerlendirilmesi

Abstract

Amaç: Yenidoğan yoğun bakım ünitelerinde (YYBÜ) eritrosit süspansiyonu (ES) transfüzyonu sıklıkla kullanılmaktadır. Çalışmamızda hastanemiz YYBÜ’de yatan hastalarda ES kullanımı; transfüzyon sıklığı, endikasyon, laboratuvar kontrolü, komplikasyonlar ve rehberlere uygunluk açısından değerlendirildi. Gereç ve Yöntemler: Tanımlayıcı nitelikte olan bu çalışmaya Sağlık Bilimleri Üniversitesi, Ankara Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları SUAM YYBÜ’nde 2016 yılında yatarak izlenen ve yatışı sırasında ES alan hastalar dâhil edildi. Hastaların demografik ve klinik özellikleri, kullanılan ES sayısı ve ilk üç transfüzyona ait laboratuvar testleri. ES kullanım endikasyonlarının Nelson Pediatric Textbook transfüzyon önerileri ve Türk Neonatoloji (TND) Derneği Kan Ürünleri Transfüzyon Rehberi’ne uygunluğu değerlendirildi. Bulgular: Çalışma süresince YYBÜ’ne yatan 1538 hastadan 191’ine toplam 633 ES transfüzyonu verilmişti, ES kullanım oranı % 12.4’tü. İlk üç transfüzyon incelemesinde TND Kan Ürünleri Transfüzyon Rehberine %66 oranında, Nelson Pediatric Textbook (2016) transfüzyon protokolüne göre ise %64 oranında uygunluk olduğu belirlendi. Birden fazla ES alan prematüre bebeklerde prematüre retinopatisi (p=0.015), intrakranial kanama (p=0.001) sıklığının yüksek olması anlamlıydı. Sonuç: Transfüzyon uygulaması ciddi ihtiyaç durumunda hayat kurtarıcı olmakla birlikte saptanan morbidite ve komplikasyonlar ile arasında neden sonuç ilişkisi olabilir. Eritrosit süspansiyonu transfüzyonu kararı öncesi her yenidoğan bebeğin bireysel olarak ve rehberler çerçevesinde dikkatle değerlendirilmesi gerekmektedir.

Keywords

• Endikasyon
• komplikasyon
• yenidoğan
• Eritrosit transfüzyonu

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