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缺氧缺血性脑病新生儿的血液制品输血实践

Blood product transfusion practices in neonates with hypoxic-ischemic encephalopathy.

作者信息

Miran Atiyeh A, Stoopler Michelle, Cizmeci Mehmet Nevzat, El Shahed Amr, Yankanah Rosanna, Danguecan Ashley, Ly Linh, Signorile Marisa, Runeckles Kyle, Fan Chun-Po Steve, Kalish Brian T

机构信息

Division of Neonatology, Department of Paediatrics, Hospital for Sick Children, Toronto, ON, M5G 1×8, Canada.

Department of Paediatrics, Hospital for Sick Children, Toronto, ON, M5G 1×8, Canada.

出版信息

J Perinatol. 2024 Oct;44(10):1485-1490. doi: 10.1038/s41372-024-02092-1. Epub 2024 Aug 15.

Abstract

OBJECTIVE

Blood product transfusion is a common practice in infants with hypoxic-ischemic encephalopathy (HIE) undoing therapeutic hypothermia (TH). The advantages and disadvantages of conservative or liberal transfusion practices in this fragile population are unknown. Study aims to characterize the transfusion practices in infants with HIE and investigate the association with outcome.

STUDY DESIGN

We conducted a retrospective cohort study at a single level IV NICU, evaluating transfusion thresholds, as well as the association between hematological abnormalities or blood product transfusions and outcomes in infants admitted with HIE.

RESULT

By univariate analysis, FFP transfusion was associated with increased in-hospital death. However, multivariate analysis adjusting for HIE severity demonstrated no association between hematological abnormality or blood product transfusion and death, nor with neurodevelopmental impairment.

CONCLUSION

No association was found between hematological blood product transfusion and death or neurodevelopmental impairment in a retrospective single NICU study of infants with HIE.

摘要

目的

在接受治疗性低温(TH)的缺氧缺血性脑病(HIE)婴儿中,输血是一种常见的做法。在这个脆弱的人群中,保守或宽松输血做法的利弊尚不清楚。本研究旨在描述HIE婴儿的输血情况,并调查其与预后的关系。

研究设计

我们在一家单一的四级新生儿重症监护病房(NICU)进行了一项回顾性队列研究,评估输血阈值,以及HIE婴儿血液学异常或血液制品输血与预后之间的关系。

结果

单因素分析显示,输注新鲜冰冻血浆(FFP)与住院死亡率增加有关。然而,在对HIE严重程度进行校正的多因素分析中,血液学异常或血液制品输血与死亡之间以及与神经发育障碍之间均无关联。

结论

在一项对HIE婴儿进行的回顾性单中心NICU研究中,未发现血液制品输血与死亡或神经发育障碍之间存在关联。

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