Bolat Fatih, Dursun Mesut, Sarıaydın Mehmet
Division of Neonatology, Department of Pediatrics, Istinye University Faculty of Medicine, Istanbul, Turkey.
Division of Neonatology, Department of Pediatrics, Biruni University Faculty of Medicine, Istanbul, Turkey.
Am J Perinatol. 2024 May;41(S 01):e1499-e1507. doi: 10.1055/a-2051-8245. Epub 2023 Mar 10.
Bronchopulmonary dysplasia (BPD) is a leading cause of morbidity and mortality in neonatal intensive care units. Our aim was to evaluate association between packed red blood cell transfusion and the development of BPD in very preterm infants.
This retrospective study of very preterm infants (mean gestational age: 27.1 ± 2.4 weeks, birth weight: 970 ± 271 g) was conducted at Biruni University (Turkey) between July 2016 and December 2020.
BPD developed in 107 of the 246 enrolled neonates, including 47 (43.9%), 27 (25.3%), and 33 (30.8%) diagnosed with mild, moderate, and severe BPD, respectively. A total of 728 transfusions were administered. The increased number (4 transfusions [2-7] vs. 1 [1-3], = 0.001) and volume of transfusions (75 mL/kg volume [40-130] vs. 20 [15-43], = 0.001) were significantly higher in infants with BPD compared to those without BPD. The transfusion volume cut-off for the prediction of BPD by receiver operating characteristic curve analysis was 42 mL/kg (sensitivity 73.6%; specificity 75%; area under the receiver-operating characteristic curve: 0.82). In multivariate analysis, multiple transfusions and larger transfusion volume were independent risk factors for moderate-severe BPD.
The increased number and volume of transfusions were associated with BPD in very preterm infants. A packed red blood cell transfusion volume ≥42 mL/kg was a statistically significant predictor of the development of BPD at a postmenstrual age of 36 weeks.
· Transfusions were found to be an important risk factor for BPD development in very premature infants.. · Number and volume of transfusion were associated with the severity of BPD.. · Optimal cut point volume of transfusion for prediction of BPD was 42 mL/kg body weight..
支气管肺发育不良（BPD）是新生儿重症监护病房发病和死亡的主要原因。我们的目的是评估极低出生体重儿中浓缩红细胞输血与BPD发生之间的关联。
这项对极低出生体重儿（平均胎龄：27.1±2.4周，出生体重：970±271g）的回顾性研究于2016年7月至2020年12月在土耳其比鲁尼大学进行。
246名纳入研究的新生儿中有107例发生了BPD，其中分别有47例（43.9%）、27例（25.3%）和33例（30.8%）被诊断为轻度、中度和重度BPD。共进行了728次输血。与未患BPD的婴儿相比，患BPD的婴儿输血次数增加（4次输血[2 - 7次]对1次[1 - 3次]，P = 0.001）和输血量增加（75mL/kg[40 - 130]对20[15 - 43]，P = 0.001）。通过受试者工作特征曲线分析预测BPD的输血体积临界值为42mL/kg（敏感性73.6%；特异性75%；受试者工作特征曲线下面积：0.82）。在多变量分析中，多次输血和更大的输血量是中度至重度BPD的独立危险因素。
极低出生体重儿中输血次数和输血量的增加与BPD有关。在孕龄36周时，浓缩红细胞输血量≥42mL/kg是BPD发生的统计学显著预测指标。
· 输血被发现是极早产儿发生BPD的重要危险因素。· 输血次数和输血量与BPD的严重程度相关。· 预测BPD的最佳输血临界体积为42mL/kg体重。
