Can Platelet Mass Index Predict Respiratory Support Duration in Late Preterm Infants with Transient Tachypnea of the Newborn?

Öz

Aim: Transient tachypnea of the newborn (TTN) is the most common respiratory problem encountered by physicians working in the neonatal intensive care unit, and its incidence is higher in late preterm infants compared to term infants. Platelets prevent pulmonary fluid collection and pulmonary edema by an unknown mechanism. Platelet function can be more accurately assessed by platelet mass index (PMI) rather than mean platelet volüme (MPV) or platelet count alone. In our study, it was planned to investigate the duration of need for respiratory support and the relationship between thrombocyte markers, especially PMI, and other respiratory outcomes in late preterm infants with the diagnosis of TTN. Materials and Methods: In this retrospective study, data of all late preterm newborns whose tachypnea lasted for at least 12 hours and who were hospitalized in the neonatal intensive care unit of Buca Seyfi Demirsoy Training and Research Hospital with the diagnosis of TTN between August 1, 2020-July 31, 2021 were analyzed from medical records. The thrombocyte markers, leukocyte and neutrophil values of the infants and respiratory support durations were compared. In addition, these parameters were evaluated in terms of possible differences according to gestational weeks. Results: 52 infants were included in the study. The median gestational week was 35 weeks (34-366/7), and the mean birth weight was 2647474. There was no correlation between total respiratory support duration or >48 hours of respiratory support in infants and platelet count, MPV, PMI, leukocyte and absolute neutrophil count (ANS). However, it was observed that the PMI values were lower in babies who received respiratory support for more than 72 hours, and this was statistically significant. In addition, it was observed that MPV value was significantly higher in babies born at 35th gestational week and ANS value was significantly higher in babies born at 36th gestational week. Conclusion: In our study, it was seen that PMI, one of the platelet markers, was associated with the need for respiratory support for more than 72 hours in late preterm infants with TTN, as the mean PMI values of these infants being lower. However, a similar relationship was not found between other platelet markers and the duration of respiratory support.

Anahtar Kelimeler

• Platelet mass index
• newborn
• transient tachypnea
• late preterm
• platelet
• mean platelet volume

Trombosit Kitle İndeksi Yenidoğanın Geçici Takipnesi Tanılı Geç Preterm Bebeklerin Solunum Destek Süresini Öngörebilir mi?

Öz

Amaç: Yenidoğanın geçici takipnesi (YDGT), yenidoğan yoğun bakımda çalışan hekimlerin en sık karşılaştığı solunumsal problem olup geç preterm bebeklerde görülme oranları, term bebeklere göre daha yüksektir. Trombositler, tam olarak bilinmeyen bir mekanizma ile akciğerde sıvı toplanmasını ve akciğer ödemini engeller. Trombositin fonksiyonu, sadece MPV (ortalama trombosit hacmi) ya da sadece trombosit sayısından ziyade, trombosit kitle indeksi ile daha doğru olarak değerlendirilebilir. Çalışmamızda, YDGT tanılı geç preterm bebeklerde sonunum destek ihtiyacı süresini ve diğer solunumsal sonlanımları ile PMI (trombosit kitle indeksi) başta olmak üzere trombosit belirteçlerinin ilişkisinin araştırılması planlanmıştır. Gereçler ve Yöntem: Bu retrospektif çalışmada, 1 Ağustos 2020-31Temmuz 2021 tarihleri arasında, YDGT tanısı ile Buca Seyfi Demirsoy Eğitim ve Araştırma Hastanesi yenidoğan yoğun bakım ünitesinde yatırılmış, takipnesi en az 12 saat sürmüş tüm geç preterm yenidoğanlara ait veriler hastane kayıtlarından incelendi. Bebeklerin trombosit belirteçleri, lökosit ve nötrofil değerleri ile solunum destek süreleri karşılaştırıldı. Ayrıca bu parametreler, gestasyonel haftalara göre olası farklılıklar açısından değerlendirildi. Bulgular: Çalışmaya 52 bebek dahil edildi. Gestasyonel hafta ortancası 35 hafta (34-366/7), ortalama doğum ağırlıkları 2647474 idi. Bebeklerin toplam solunum destek süreleri ya da >48 saat solunum desteği almaları ile trombosit sayısı, MPV, PMI, lökosit ve absolut nötrofil sayısı (ANS) ile ilişkili saptanmadı. Ancak 72 saatten fazla solunum desteği alan bebeklerde PMI değerlerinin daha düşük olduğu ve bunun da istatistiksel olarak anlamlı olduğu görüldü. Ayrıca MPV değerinin 35.gestasyon haftasında, ANS değerinin ise 36. gestasyon haftasında doğan bebeklerde anlamlı olarak yüksek olduğu görüldü. Sonuç: Çalışmamızda, trombosit belirteçlerinden, PMI’nın, YDGT tanılı geç preterm bebeklerin 72 saatten uzun süre solunum desteği almaları ile ilişkili olduğu, bu bebeklerin ortalama PMI değerlerinin daha düşük olduğu görülmüştür. Ancak benzer bir ilişki diğer trombosit belirteçleri ile solunum destek süresi arasında saptanmamıştır.

Anahtar Kelimeler

• Trombosit kitle indeksi
• yenidoğan
• geçici takipne
• geç preterm
• trombosit
• ortalama trombosit hacmi

Kaynakça

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