NON-KARDİYAK CERRAHİ GİRİŞİM GEÇİREN PEDİATRİK HASTALARDA ERİTROSİT TRANSFÜZYONUNUN HASTA SONUÇLARINA ETKİSİ

Yıl 2022, , 727 - 738, 20.06.2022

Ayda Kebapçı , Pelin Karaçay

https://doi.org/10.33715/inonusaglik.1019410

Öz

Non-kardiyak cerrahi girişim geçiren hastalarda eritrosit transfüzyonunun hasta sonuçlarına etkisini inceleyen çalışmaların sayısı oldukça sınırlıdır. Bu çalışmada amaç, non-kardiyak cerrahi girişim geçiren pediatrik hastalarda, eritrosit süspansiyonu (ES) transfüzyonunun hasta sonuçlarına etkisinin belirlenmesidir. Tanımlayıcı ve karşılaştırıcı nitelikte olan bu retrospektif çalışmaya, 2018-2020 yılında özel bir üniversite hastanesinde yatan, elektif non-kardiyak cerrahi girişim geçiren 144 çocuk hasta (ES uygulanan n=52; ES uygulanmayan n=92) dahil edildi. Verilerinin analizinde, tanımlayıcı istatistikler ve hasta sonuçlarının karşılaştırılmasında Mann-Whitney U testi kullanıldı. Çalışmada, hastaların taburculuk sırası hemoglobin (Hgb) düzeyi ve hastanede toplam kalış süreleri primer hasta sonucu ölçütleri olarak belirlendi. Her iki grup arasında taburculuk sırası bakılan Hgb değerleri (10.2 vs 10.8) arasında istatistiksel olarak anlamlı bir fark olmadığı belirlendi. Hastanede toplam yatış süreleri incelendiğinde ise; ES transfüzyonu uygulanan gruptaki hastaların hastanede yatış süresinin uygulanmayanlara göre (19.3 gün vs 6.2 gün) istatistiksel olarak anlamlı şekilde yüksek olduğu belirlendi (p<.01). Eritrosit transfüzyonu, non-kardiyak cerrahi girişim geçiren hastalarda hastanede kalış süresini uzattığını düşündürmüştür. Non-kardiyak cerrahi girişim geçiren pediatrik hastalara yönelik kısıtlayıcı transfüzyon stratejisinin kullanımına gereksinim vardır. Ayrıca multidisipliner ekip ve hemovijilans hemşireleri arasındaki iletişim arttırılarak ve hastaların klinik bulguları ve tanısı dikkate alınarak gereksiz transfüzyonu engelleyecek yaklaşımlar uygulanmalıdır.

Anahtar Kelimeler

Cerrahi, Eritrosit Süspansiyonu, Non-Kardiyak, Pediatri, Transfüzyon

The Effect of Erythrocyte Transfusion on Pediatric Patient Outcomes in Non-Cardiac Surgery

Öz

The number of studies examining the effect of erythrocyte transfusion on patient outcomes in patients undergoing non-cardiac surgery is very limited. This study aimed to determine the effect of erythrocyte transfusion on patient outcomes in pediatric patients undergoing non-cardiac surgery. This descriptive, comparative, and retrospective study included 144 pediatric patients who underwent elective, non-cardiac surgery in a private university hospital in 2018-2020. In the analysis of the data; the Mann-Whitney U test was applied to compare descriptive statistics and patient outcomes. In the study, the hemoglobin level at the discharged time of the patients and the total hospitalization time were determined as the primary patient outcome criteria. It was determined that there was no statistically significant difference between the two groups in terms of Hgb values (10.2 vs 10.8) at discharge (p > .01). When the hospitalization time was examined; it was determined that the hospitalization period (19.3 days) of the patients in the experimental group was statistically significantly higher than the control group (6.2 days) (p < .01). Erythrocyte transfusion increased hospitalization time in hospital of pediatric patients undergoing non-cardiac surgery. There is a need for the use of a restrictive transfusion strategy for pediatric patients undergoing non-cardiac surgery. In addition, approaches should be implemented to prevent unnecessary transfusions by increasing the communication between the multidisciplinary team and hemovigilance nurses and considering the clinical findings and diagnosis of patients.

Anahtar Kelimeler

Erythrocyte suspension, Non-Cardiac, Pediatrics, Surgery, Transfusion

Kaynakça

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