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极低出生体重儿输血相关早产儿贫血的危险因素:一项回顾性研究。

Risk factors associated with anemia of prematurity requiring red blood cell transfusion in very low birth weight infants: a retrospective study.

机构信息

Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea.

Chungbuk National University College of Medicine, 1 Chungdae-ro, Seowon-gu, Cheongju, 28644, Korea.

出版信息

BMC Pediatr. 2024 Sep 30;24(1):623. doi: 10.1186/s12887-024-05102-5.

Abstract

BACKGROUND

Anemia of prematurity (AOP) is prevalent among very low birth weight infants (VLBWIs). Red blood cell (RBC) transfusions, while necessary for managing AOP, have been linked to adverse neonatal outcomes.

METHODS

This retrospective study analyzed the medical records of 98 VLBWIs (24-31 weeks gestation) admitted to the Chungbuk National University Hospital neonatal intensive care unit. Infants were categorized based on RBC transfusion status and birth weight (< 1000 g and 1000-1499 g). Clinical outcomes between the groups were compared.

RESULTS

Of the 98 infants, 35 (35.7%) received RBC transfusions. The RBC transfusion group exhibited significantly higher incidence of bronchopulmonary dysplasia ([Formula: see text]moderate), prolonged invasive mechanical ventilation, intraventricular hemorrhage (grades 1-2), extended time to full enteral feeding, and extended total parenteral nutrition (TPN) compared to the non-RBC transfusion group. Birth weight was inversely correlated with the number of RBC transfusions (p = 0.004). The duration of invasive mechanical ventilation and TPN administration were positively associated with the number of RBC transfusions (p < 0.001 and p = 0.025, respectively).

CONCLUSIONS

The RBC transfusion group experienced more comorbidities than the non-transfusion group. Birth weight, duration of invasive ventilation, and duration of TPN were associated with the number of RBC transfusions. Strategies to reduce the duration of invasive ventilation and early discontinuation of TPN may mitigate the need for RBC transfusions in AOP.

摘要

背景

早产儿贫血(AOP)在极低出生体重儿(VLBWI)中很常见。尽管红细胞(RBC)输血对于治疗 AOP 是必要的,但它与新生儿不良结局有关。

方法

本回顾性研究分析了入住忠北国立大学医院新生儿重症监护病房的 98 例 VLBWI(24-31 周胎龄)的病历。根据 RBC 输血情况和出生体重(<1000g 和 1000-1499g)对婴儿进行分类。比较两组间的临床结局。

结果

在 98 例婴儿中,有 35 例(35.7%)接受了 RBC 输血。RBC 输血组发生支气管肺发育不良([Formula: see text]中度)、延长有创机械通气、脑室内出血(1-2 级)、完全肠内喂养时间延长和全胃肠外营养(TPN)延长的发生率明显高于非 RBC 输血组。出生体重与 RBC 输血次数呈负相关(p=0.004)。有创机械通气和 TPN 时间与 RBC 输血次数呈正相关(p<0.001 和 p=0.025)。

结论

RBC 输血组比非输血组有更多的合并症。出生体重、有创通气时间和 TPN 时间与 RBC 输血次数有关。减少有创通气时间和早期停止 TPN 的策略可能会减少 AOP 中对 RBC 输血的需求。

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