Ionescu Alin, Mihăilescu Alexandra, Chiriță-Emandi Adela, Munagala Nitesh, David Vlad Laurențiu, Dumache Raluca, Săndesc Dorel, Bedreag Ovidiu, Folescu Roxana, Bratosin Felix, Barata Paula Irina, Cristescu Dan-Mihai, Săndesc Mihai Alexandru
Center for Preventive Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Doctoral School, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Diagnostics (Basel). 2024 Oct 4;14(19):2216. doi: 10.3390/diagnostics14192216.
This retrospective study aimed to evaluate the efficacy of preoperative blood transfusions in correcting anemia for pediatric patients with congenital malformations (CMs) versus those with acute abdomen (AA) conditions. The study hypothesized that the response to transfusions might vary significantly between these groups due to the differences in the underlying pathology and clinical status.
The study included 107 pediatric patients admitted to Timisoara 'Louis Turcanu' Emergency Hospital for Children between January 2015 and May 2023, who required blood transfusions for preoperative anemia. Hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) were assessed at admission, 48 h post-transfusion, and at discharge. Statistical analyses, including Student's -test, Pearson correlation, and chi-square tests, were utilized to compare outcomes between the groups. The study population was divided into 53 children with CM and 54 with AA.
Initial analyses showed that children with CM had statistically significantly higher baseline HGB (8.54 ± 1.00 g/dL vs. 7.87 ± 1.02 g/dL, = 0.001) and HCT (26.07 ± 3.98% vs. 23.95 ± 2.90%, = 0.002) compared to those with AA. Post-transfusion, children with CM exhibited a greater increase in HGB, with the highest increases noted in patients with central nervous system defects (mean increase of 3.67 g/dL, = 0.038). In contrast, the increases in HGB for children with AA were less pronounced, with the highest being 2.03 g/dL in those with peritonitis ( = 0.078).
No significant gender differences were noted in response to transfusion. Children with congenital malformations respond more effectively to preoperative blood transfusions compared to those with acute abdomen conditions. These findings suggest that differential transfusion strategies may be required based on the underlying medical condition to optimize the management of preoperative anemia in pediatric patients. Tailoring transfusion approaches according to specific patient needs and conditions could enhance clinical outcomes and resource utilization in pediatric surgical settings.
本回顾性研究旨在评估术前输血对先天性畸形（CM）患儿与急腹症（AA）患儿纠正贫血的疗效。该研究假设，由于潜在病理和临床状况的差异，这些组对输血的反应可能有显著差异。
该研究纳入了2015年1月至2023年5月期间入住蒂米什瓦拉“路易·图尔卡努”儿童医院的107例因术前贫血需要输血的儿科患者。在入院时、输血后48小时和出院时评估血红蛋白（HGB）、血细胞比容（HCT）和红细胞计数（RBC）。采用包括学生t检验、Pearson相关性分析和卡方检验在内的统计分析方法比较各组结果。研究人群分为53例CM患儿和54例AA患儿。
初步分析显示，与AA患儿相比，CM患儿的基线HGB（8.54±1.00 g/dL对7.87±1.02 g/dL，P = 0.001）和HCT（26.07±3.98%对23.95±2.90%，P = 0.002）在统计学上显著更高。输血后，CM患儿的HGB升高幅度更大，中枢神经系统缺陷患者的升高幅度最高（平均升高3.67 g/dL，P = 0.038）。相比之下，AA患儿的HGB升高不太明显，腹膜炎患儿的最高升高为2.03 g/dL（P = 0.078）。
在输血反应方面未观察到显著的性别差异。与急腹症患儿相比，先天性畸形患儿对术前输血的反应更有效。这些发现表明，可能需要根据潜在疾病采取不同的输血策略，以优化儿科患者术前贫血的管理。根据特定患者的需求和状况调整输血方法，可以提高儿科手术环境中的临床疗效和资源利用效率。
