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Anemia and transfusion policies in premature infants

Yıl 2022, Cilt 15, Sayı 2, 407 - 424, 01.04.2022
https://doi.org/10.31362/patd.1031857

Öz

In the neonatal period, anemia may be physiological as well as many prenatal, perinatal and postnatal causes; however, especially in some extremely premature infants, one of the most important causes of anemia is iatrogenic blood losses. The decision of red blood cells transfusion in a newborn with anemia is made in order to maintain blood hemoglobin or hematocrit levels which will optimize tissue oxygenation. For that, the baby's blood hemoglobin and/or hematocrit level and clinical status are important practically. Considering the many potential complications of red blood cells transfusion, it seems appropriate to make an individualized transfusion decision in the light of current practices and clinical findings while deciding on transfuison of red blood cells for premature infants, however the main goal should be to prevent the development of anemia in premature infants.
In this review, anemia of prematurity, diagnosis, transfusion therapy, complications and prevention strategies have been tried to be given in the light of recent current practices.

Kaynakça

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  • 21. Fergusson DA, Hebert P, Hogan DL, LeBel L, Rovinez-Bouali N, Smyth JA. Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low-birth-weight infants: the ARIPI randomized trial. JAMA 2012;308(14):1443-1451. https://dx.doi.org/10.1001/2012.jama.11953.
  • 22. Kirpalani H, Whyte RK. What is new about transfusions for preterm infants? An uptodate. Neonatology 2019;115:406-410. https://dx.doi.org/10.1159/000499048.
  • 23. Franz AR, Engel C, Bassler D, et al. Effects of Liberal vs Restrictive Transfusion Thresholds on Survival and Neurocognitive Outcomes in Extremely Low-Birth-Weight Infants The ETTNO Randomized Clinical Trial. JAMA 2020;324(6):560-570. https://dx.doi.org/10.1001/jama.2020.10690.
  • 24. Kirpalani H, Bell EF, Johnson KJ, et al. A randomized trial of higher versus lower hemoglobin transfusion threshold for extremely low birth weight (ELBW) infants: The Transfusion of Prematures (TOP) Trial. 2020. Available at:https://plan.core-apps.com/pas2020/abstract/6edec56c63f592adb37f205ea944d7d8.
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  • 27. Whyte RK, Kirpalani H, Asztalos EV, et al., the PINTOS Study Group study. Neurodevelopmental outcome of extremely low birth weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion. Pediatrics 2009;123:207–213. https://dx.doi.org/10.1542/peds.2008-0338.
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Prematürede anemi ve transfüzyon politikaları

Yıl 2022, Cilt 15, Sayı 2, 407 - 424, 01.04.2022
https://doi.org/10.31362/patd.1031857

Öz

Yenidoğan döneminde anemi, fizyolojik olabildiği gibi prenatal, perinatal ve postnatal pek çok neden sonucu gelişebilmekte, ancak özellikle aşırı prematüre bebeklerde en önemli anemi nedenlerinden birisini iyatrojenik kan kayıpları oluşturmaktadır. Anemi saptanan bir yenidoğanda eritrosit transfüzyon kararı doku oksijenizasyonunu optimize edecek kan hemoglobin veya hematokrit düzeylerinin devamlılığının sağlanması amacıyla verilmektedir. Bunun için ise pratikte bebeğin kan hemoglobin ve/veya hematokrit düzeyi ve klinik durumu önem kazanmaktadır. Eritrosit transfüzyonunun pek çok potansiyel komplikasyonu da düşünüldüğünde prematüre bebeklere eritrosit transfüzyonu kararı verilirken kar-zarar oranı gözetilerek, güncel uygulamalar ışığında klinik bulguları eşliğinde bireyselleştirilmiş transfüzyon kararı verilmesi uygun gözükmektedir, ancak asıl amaç prematüre bebeklerde anemi gelişiminin önlenmesi olmalıdır. Bu derlemede prematüre anemisi, tanısı, transfüzyon tedavisi, komplikasyon ve korunma stratejileri son güncel uygulamalar ışığında verilmeye çalışılmıştır.

Kaynakça

  • 1. Letterio J, Poteva I, Petrosiute A, Ahuja S. Hematologic and oncologic problems in the fetüs and neonate. In: Martin R, Fanaroff AA, Walsh MC, eds. Fanaroff & Martin’s neonatal-perinatal medicine, diseases of the fetus and infant. 11th ed. Philadelphia: Elsevier, 2020;1416-1475.
  • 2. Gomella TL, Eyal FG, Bany-Mohammed F. Gomella’s Neonatology management, procedures, on-call problems, diseases, and drugs. 8th ed. New York: Mc Graw Hill, 2020;815-822.
  • 3. Akpan U, Orth E, Moore R, et al. The hematopoietic system. In: Jnah AJ, Trembath AN, eds. Fetal and neonatal physiology for the advanced practice nurse. New York: Springer Publishing Company, 2019;381-454.
  • 4. Lopriore E. Updates in red blood cell and platelet transfusions in preterm neonates. Am J Perinatol 2019;36(Suppl S2):S37-S40. https://dx.doi.org/ 10.1055/s-0039-1691775.
  • 5. Christensen RD. Neonatal ertythrocyte disorders. In: Gleason CA, Juul SE, eds. Avery’s diseases of the newborn. 10th ed. Philadelphia: Elsevier, 2018;1152-1179.
  • 6. Zerra PE, Josephson CD. Transfusion in neonatal patients: review of evidence-based guidelines. Clin Lab Med 2021;41:15-34. https://dx.doi.org/10.1016/j.cll.2020.10.002.
  • 7. Steiner L. Erythrocyte. In: Chess PA, ed. Avery’s neonatology board review. 1st ed. 2019;288-295.
  • 8. Cibulskis CC, Maheshwari A, Rao R, Mathur AM. Anemia of prematurity: how low is too low? J Perinatol 2021;41(6):1244-1257. https://dx.doi.org/ 10.1038/s41372-021-00992-0.
  • 9. Christensen RD, Henry E. Reference intervals in neonatal hematology. Clin Perinatol 2015;42:483-497. https://dx.doi.org/10.1016/j.clp.2015.04.005.
  • 10. Saito-Benz M, Flanagan P, Berry MJ. Management of anaemia in pre-term infants. Br J Haematol 2020;188(3):354–366. https://dx.doi.org/10.1111/bjh.16233.
  • 11. Del Vecchio A, Franco C, Petrillo F, D’Amato G. Neonatal transfusion practice: when do neonates need red blood cells or platelets? Am J Perinatol 2016;33:1079-1084. https://dx.doi.org/10.1055/s-0036-1586106.
  • 12. Howarth C, Banerjee J, Aladangady N. Red blood cell transfusion in preterm infants: current evidence and controversies. Neonatology 2018;114:7-16. https://dx.doi.org/10.1159/000486584.
  • 13. Kalteren WS, Verhagen EA, Mintzer JP, Bos AF, Kooi EMW. Anemia and red blood cell transfusions, cerebral oxygenation, brain injury and development, and neurodvelomental outcpme in preterm infants: a systemic review. Front Pediatr 2021;9:644462. https://dx.doi.org/10.3389/fped.2021.644462.
  • 14. Dror Y, Chan AKC, Baker JM, Avila ML. Hematology. In: MacDonald MG, Seshia MMK, eds. Avery’s neonatology pathophysiology & management of the newborn. 7th ed. Philadelphia: Wolters Kluwer, 2016;872-929.
  • 15. Lanzkowsky P. Anemia during the neonatal period. In: Lanzkowsky P, Lipton JM, Fish JD, eds. Lanzkowsky’s manual of pediatric hematology and oncology. 6th ed. Amsterdam: Elsevier, 2016;51-68.
  • 16. Perk Y. Atasay B, Çetinkaya M. Türk Neonatoloji Derneği Kan Ürünleri Transfüzyon Rehberi 2021 Güncellemesi.
  • 17. Sweet DG, Carnielli V, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology 2019;115:432–450. https://dx.doi.org/10.1159/000499361.
  • 18. Jacquot C, Mo YD, Luban NLC. Blood component therapy for the neonate. In: Martin R, Fanaroff AA, Walsh MC, eds. Fanaroff & Martin’s neonatal-perinatal medicine, diseases of the fetus and infant. 11th ed. Philadelphia: Elsevier, 2020;1476-1503.
  • 19. Villeneuve A, Arsenault V, Lacroix J, Tucci M. Neonatal red blood cell transfusion. Vox Sang 2021;116:366-378.https://dx.doi.org/10.1111/vox.13036.
  • 20. Shah A, Brunskill SJ, Desborough MJ, Doree C, Trivella M, Stanworth SJ. Transfusion of red blood cells stored for shorter versus longer duration for all conditions. Cochrane Database Syst Rev 2018;12(12):CD010801. https://dx.doi.org/10.1002/14651858.CD010801.pub3.
  • 21. Fergusson DA, Hebert P, Hogan DL, LeBel L, Rovinez-Bouali N, Smyth JA. Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low-birth-weight infants: the ARIPI randomized trial. JAMA 2012;308(14):1443-1451. https://dx.doi.org/10.1001/2012.jama.11953.
  • 22. Kirpalani H, Whyte RK. What is new about transfusions for preterm infants? An uptodate. Neonatology 2019;115:406-410. https://dx.doi.org/10.1159/000499048.
  • 23. Franz AR, Engel C, Bassler D, et al. Effects of Liberal vs Restrictive Transfusion Thresholds on Survival and Neurocognitive Outcomes in Extremely Low-Birth-Weight Infants The ETTNO Randomized Clinical Trial. JAMA 2020;324(6):560-570. https://dx.doi.org/10.1001/jama.2020.10690.
  • 24. Kirpalani H, Bell EF, Johnson KJ, et al. A randomized trial of higher versus lower hemoglobin transfusion threshold for extremely low birth weight (ELBW) infants: The Transfusion of Prematures (TOP) Trial. 2020. Available at:https://plan.core-apps.com/pas2020/abstract/6edec56c63f592adb37f205ea944d7d8.
  • 25. Bell EF, Strauss RG, Widness JA, et al. Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants. Pediatrics 2005; 115(6):1685–1691. https://dx.doi.org/10.1542/peds.2004-1884.
  • 26. Kirpalani H, Whyte RK, Andersen C, et al. The Prematur Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion treshold for extremely low birth weight infants. J Pediatr 2006;149:301-307. https://dx.doi.org/10.1016/j.jpeds.2006.05.011.
  • 27. Whyte RK, Kirpalani H, Asztalos EV, et al., the PINTOS Study Group study. Neurodevelopmental outcome of extremely low birth weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion. Pediatrics 2009;123:207–213. https://dx.doi.org/10.1542/peds.2008-0338.
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Ayrıntılar

Birincil Dil Türkçe
Konular Pediatri
Yayınlanma Tarihi Nisan 2022
Bölüm Derleme
Yazarlar

Özmert M.a. ÖZDEMİR (Sorumlu Yazar)
Pamukkale Ünv. Tıp Fak. Çocuk Sağlığı ve Hastalıkları, Neonatoloji Bilim Dalı
0000-0002-2499-4949
Türkiye

Yayımlanma Tarihi 1 Nisan 2022
Kabul Tarihi 9 Aralık 2021
Yayınlandığı Sayı Yıl 2022, Cilt 15, Sayı 2

Kaynak Göster

Bibtex @derleme { patd1031857, journal = {Pamukkale Tıp Dergisi}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2022}, volume = {15}, number = {2}, pages = {407 - 424}, doi = {10.31362/patd.1031857}, title = {Prematürede anemi ve transfüzyon politikaları}, key = {cite}, author = {Özdemir, Özmert M.a.} }
APA Özdemir, Ö. M. (2022). Prematürede anemi ve transfüzyon politikaları . Pamukkale Tıp Dergisi , 15 (2) , 407-424 . DOI: 10.31362/patd.1031857
MLA Özdemir, Ö. M. "Prematürede anemi ve transfüzyon politikaları" . Pamukkale Tıp Dergisi 15 (2022 ): 407-424 <https://dergipark.org.tr/tr/pub/patd/issue/65532/1031857>
Chicago Özdemir, Ö. M. "Prematürede anemi ve transfüzyon politikaları". Pamukkale Tıp Dergisi 15 (2022 ): 407-424
RIS TY - JOUR T1 - Prematürede anemi ve transfüzyon politikaları AU - Özmert M.a. Özdemir Y1 - 2022 PY - 2022 N1 - doi: 10.31362/patd.1031857 DO - 10.31362/patd.1031857 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 407 EP - 424 VL - 15 IS - 2 SN - -1308-0865 M3 - doi: 10.31362/patd.1031857 UR - https://doi.org/10.31362/patd.1031857 Y2 - 2021 ER -
EndNote %0 Pamukkale Tıp Dergisi Prematürede anemi ve transfüzyon politikaları %A Özmert M.a. Özdemir %T Prematürede anemi ve transfüzyon politikaları %D 2022 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 15 %N 2 %R doi: 10.31362/patd.1031857 %U 10.31362/patd.1031857
ISNAD Özdemir, Özmert M.a. . "Prematürede anemi ve transfüzyon politikaları". Pamukkale Tıp Dergisi 15 / 2 (Nisan 2022): 407-424 . https://doi.org/10.31362/patd.1031857
AMA Özdemir Ö. M. Prematürede anemi ve transfüzyon politikaları. Pam Tıp Derg. 2022; 15(2): 407-424.
Vancouver Özdemir Ö. M. Prematürede anemi ve transfüzyon politikaları. Pamukkale Tıp Dergisi. 2022; 15(2): 407-424.
IEEE Ö. M. Özdemir , "Prematürede anemi ve transfüzyon politikaları", Pamukkale Tıp Dergisi, c. 15, sayı. 2, ss. 407-424, Nis. 2022, doi:10.31362/patd.1031857
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