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三级护理中心中体重<1500克和/或孕周<32周的早产儿的输血支持:一项描述性研究。

Transfusion support in preterm neonates <1500 g and/or <32 weeks in a tertiary care center: A descriptive study.

作者信息

Shanmugha Priya R A, Krishnamoorthy R, Panicker Vinod Kumar, Ninan Binu

机构信息

Department of Transfusion Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

Department of Neonatology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

出版信息

Asian J Transfus Sci. 2018 Jan-Jun;12(1):34-41. doi: 10.4103/ajts.AJTS_148_16.

Abstract

BACKGROUND

Lack of recent studies focusing on indications, pattern, and benefits of transfusions in low birth weight (B.Wt) and low gestational age (GA) preterm neonates prompted us to undertake this study.

AIM

To estimate the transfusion requirements and outcomes in preterm neonates <1500 g and/or <32 weeks.

SETTINGS AND DESIGN

This is a cross-sectional study conducted over a period of 2 years in a tertiary care center.

MATERIALS AND METHODS

This study was conducted with 101 preterm neonates <1500 g and/or <32 weeks who received blood transfusions in the Neonatal Intensive Care Unit. Restrictive pattern of transfusion was followed. Demographic details and antenatal, neonatal, laboratory, and transfusion parameters were collected.

STATISTICAL ANALYSIS USED

Statistical analyses were performed using SPSS 16.

RESULTS

The study participants received 311 transfusions. Transfusion requirements decreased with increasing GA and B.Wt. Majority of blood transfusions occurred during the first 2 weeks of life. Packed red blood cells (PRBCs) were the most frequent blood components transfused. Ninety-six percent of the study population had an uneventful transfusion. Mean hemoglobin improvement after PRBC transfusions was 2.3 ± 2.1 g/dl. Improvement in apnea occurred in 76% PRBC transfusions. Infants with sepsis, patent ductus arteriosus, bronchopulmonary dysplasia, disseminated intravascular coagulation, and dyselectrolytemia received more number of transfusions.

CONCLUSION

This study would serve as an audit for neonatal blood transfusion therapy. Close adherence to neonatal transfusion policy and restrictive transfusion guidelines helps reduce inappropriate use of blood products and adverse transfusion reactions.

摘要

背景

近期缺乏针对低出生体重(B.Wt)和低胎龄(GA)早产儿输血的适应症、模式及益处的研究,促使我们开展此项研究。

目的

评估体重<1500克和/或胎龄<32周的早产儿的输血需求及结局。

设置与设计

这是一项在三级医疗中心进行的为期2年的横断面研究。

材料与方法

本研究纳入了101例体重<1500克和/或胎龄<32周且在新生儿重症监护病房接受输血的早产儿。遵循限制性输血模式。收集了人口统计学细节以及产前、新生儿、实验室和输血参数。

所用统计分析方法

使用SPSS 16进行统计分析。

结果

研究参与者共接受了311次输血。输血需求随着GA和B.Wt的增加而减少。大多数输血发生在出生后的前2周。浓缩红细胞(PRBCs)是最常输注的血液成分。96%的研究人群输血过程顺利。输注PRBC后平均血红蛋白改善值为2.3±2.1克/分升。76%的PRBC输血后呼吸暂停情况有所改善。患有败血症、动脉导管未闭、支气管肺发育不良、弥散性血管内凝血和电解质紊乱的婴儿接受的输血次数更多。

结论

本研究可作为新生儿输血治疗的一项审计。严格遵守新生儿输血政策和限制性输血指南有助于减少血液制品的不当使用及不良输血反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8481/5850695/55a990f15b8d/AJTS-12-34-g001.jpg

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