Uezima Cristina Lika, Barreto Ariane Moreira, Guinsburg Ruth, Chiba Akemi Kuroda, Bordin José Orlando, Barros Melca Maria O, dos Santos Amélia Miyashiro N
Unifesp, Escola Paulista de Medicina, São PauloSP, Brasil.
Rev Paul Pediatr. 2013 Sep;31(3):285-92. doi: 10.1590/S0103-05822013000300003.
In preterm newborn infants transfused with erythrocytes stored up to 28 days, to compare the reduction of blood donor exposure in two groups of infants classified according to birth weight.
A prospective study was conducted with preterm infants with birth weight <1000 g (Group 1) and 1000-1499 g (Group 2), born between April, 2008 and December, 2009. Neonates submitted to exchange transfusions, emergency erythrocyte transfusion, or those who died in the first 24 hours of life were excluded. Transfusions were indicated according to the local guideline using pediatric transfusion satellite bags. Demographic and clinical data, besides number of transfusions and donors were assessed. . Logistic regression analysis was performed to determine factors associated with multiple transfusions.
30 and 48 neonates were included in Groups 1 and 2, respectively. The percentage of newborns with more than one erythrocyte transfusion (90 versus 11%), the median number of transfusions (3 versus 1) and the median of blood donors (2 versus 1) were higher in Group 1 (p<0.001), compared to Group 2. Among those with multiple transfusions, 14 (82%) and one (50%) presented 50% reduction in the number of blood donors, respectively in Groups 1 and 2. Factors associated with multiple transfusions were: birth weight <1000 g (OR 11.91; 95%CI 2.14-66.27) and presence of arterial umbilical catheter (OR 8.59; 95%CI 1.94-38.13), adjusted for confounders.
The efficacy of pediatrics satellites bags on blood donor reduction was higher in preterm infants with birth weight <1000 g.
在输注储存时间长达28天的红细胞的早产新生儿中,比较根据出生体重分类的两组婴儿减少献血者暴露的情况。
对2008年4月至2009年12月出生的出生体重<1000g的早产儿(第1组)和1000 - 1499g的早产儿(第2组)进行前瞻性研究。排除接受换血输血、紧急红细胞输血或在出生后24小时内死亡的新生儿。根据当地指南使用儿科输血卫星袋进行输血。评估人口统计学和临床数据,以及输血次数和献血者数量。进行逻辑回归分析以确定与多次输血相关的因素。
第1组和第2组分别纳入30例和48例新生儿。与第2组相比,第1组中接受不止一次红细胞输血的新生儿百分比(90%对11%)、输血中位数(3次对1次)和献血者中位数(2个对1个)更高(p<0.001)。在多次输血的患者中,第1组和第2组分别有14例(82%)和1例(50%)献血者数量减少了50%。与多次输血相关的因素为:出生体重<1000g(比值比11.91;95%置信区间2.14 - 66.27)和存在脐动脉导管(比值比8.59;95%置信区间1.94 - 38.13),经混杂因素校正。
儿科卫星袋在减少献血者方面的效果在出生体重<1000g的早产儿中更高。