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新生儿重症监护病房的红细胞输血实践:来自三级医疗中心的经验

Red Cell Transfusion Practices in Neonatal Intensive Care Unit: An Experience from Tertiary Care Centre.

作者信息

Dogra Kanchan, Kaur Gagandeep, Basu Sabita, Chawla Deepak

机构信息

1Department of Transfusion Medicine, AIIMS, New Delhi, India.

2Department of Transfusion Medicine, GMCH, Sector-32, Chandigarh, India.

出版信息

Indian J Hematol Blood Transfus. 2018 Oct;34(4):671-676. doi: 10.1007/s12288-018-0959-4. Epub 2018 Apr 12.

Abstract

Red cells are the most often transfused blood components during the neonatal period. The aim of the present study was to obtain information regarding the relationship of red cell transfusion with clinical outcomes and to evaluate red cell transfusion practices in neonatal centre of a tertiary care centre. The clinical history, blood component details and laboratory parameters were evaluated with clinical outcomes. The neonates requiring transfusion of red cells were then followed up in the Blood bank for various laboratory parameters. Clinical parameters and clinical outcome were noted from case files. During the study period, 291 neonates were admitted in NICU. 2 neonates were excluded as they were congenitally malformed. Out of 289 admitted neonates, 61 neonates (21.1%) received blood and blood component transfusions. Out of 61 neonates, 20 received red cell transfusions. Mean donor exposure of red cells was 1.2. The mean volume of transfused red cell was 39.6 ml with mean age of red cells was 3.6 days. The mean pre- and post-transfusion Hct was 25.3 and 30.4%, respectively. The most common indication for red cell transfusion was low haemoglobin. There was a significant increase in lactate level and decrease in base excess in transfused neonates. However, no statistically significant correlations were found between transfusions and neonatal weight gain, apnoea, respiratory support and mortality. Transfusion of red cells has significant effect on laboratory parameters as compared to clinical parameters such as weight gain, episodes of apnoea and respiratory support.

摘要

红细胞是新生儿期最常输注的血液成分。本研究的目的是获取有关红细胞输注与临床结局关系的信息,并评估三级医疗中心新生儿中心的红细胞输注实践。将临床病史、血液成分详细信息和实验室参数与临床结局进行评估。然后在血库对需要输注红细胞的新生儿进行各种实验室参数的随访。从病例档案中记录临床参数和临床结局。在研究期间,291名新生儿入住新生儿重症监护病房(NICU)。2名新生儿因先天性畸形被排除。在289名入院新生儿中,61名新生儿(21.1%)接受了血液及血液成分输注。在61名新生儿中,20名接受了红细胞输注。红细胞的平均供体暴露次数为1.2次。输注红细胞的平均体积为39.6毫升,红细胞的平均年龄为3.6天。输血前和输血后的平均血细胞比容分别为25.3%和30.4%。红细胞输注最常见的指征是血红蛋白水平低。输注红细胞的新生儿乳酸水平显著升高,碱剩余降低。然而,在输血与新生儿体重增加、呼吸暂停、呼吸支持及死亡率之间未发现统计学上的显著相关性。与体重增加、呼吸暂停发作和呼吸支持等临床参数相比,红细胞输注对实验室参数有显著影响。

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