Fatores associados à transfusão de concentrado de hemácias em prematuros de uma unidade de terapia intensiva

Abstract

Factors associated with packed red blood cell transfusions in premature infants in an intensive care unit Fatores associados à transfusão de concentrado de hemácias em prematuros de uma unidade de terapia intensiva ORIGINAL ARTICLE INTRODUCTION Anemia occurs frequently in premature infants, which makes this population prone to transfusion treatments. (1) Packed red blood cells are the most frequently administered blood products to newborns, and these transfusions are generally necessary in two situations: 1) to guarantee adequate tissue oxygenation during intensive care treatment and 2) to treat significantly symptomatic anemia. (2) The repercussions of transfusions and the adoption of policies to reduce blood transfusions have become enormous challenges because more premature newborns survive anemia. (1) Preterm infants with gestational ages <30 weeks, birth weights <1,000 g, or severe infectious diseases are candidates for blood transfusions. (3) Several reasons may underlie the occurrence of anemia in premature infants. The time to cut the umbilical cord in the delivery room determines the newborn's hematocrit. Delays in the clamping of the umbilical cord increases the blood volume shortly after birth, which improves

Transfusion practices in a neonatal intensive care unit in a city in Brazil

“…Forty-five to 85% of premature newborns in a neonatal intensive care unit (NICU) receive at least one blood transfusion during hospital stay, making them the population group that is most at risk to transfusion-related adverse effects and complications. 1 , 2 , 3 , 4 , 5 , 6 …”

Saberes do enfermeiro para o cuidado no processo transfusional em recém-nascidos

“…Early detection of adverse events is a strategy to minimize damage to the health of neonates, and nurses should intervene as quickly as possible because when a blood component is administered, the above mentioned transfusion reactions may occur during the process, immediately or later (18) . Therefore, it is essential that nurses are aware of the three "Rs": Recognize, Respond to and Report transfusion reactions (19), to be able to take the necessary actions as soon as possible. Some statements follow: If a transfusion reaction is suspected, the procedure must be immediately interrupted and will only be restarted then the suspicion is discarded.…”

“…Undoubtedly, the transfusion therapy is a process that, even when appropriately recommended and administered, involves health risks. So, it is important to observe the blood therapy cycle that begins with the donor selection, serology and immunohematology, processing and fractionation of plasma, dispensation, transfusion and post transfusion evaluation (9) .…”

“…However, many nurses feel unprepared to provide the appropriate care to neonates who need blood transfusion (9) .…”

Por que é importante analisar fatores associados à indicação de transfusões de hemácias em prematuros?

“…(19) In this context, Freitas and Franceschini bring their contribution to this issue of the Revista Brasileira de Terapia Intensiva. (20) The authors studied 254 premature infants born in one center in Minas Gerais State, Brazil, and 100 of these infants (39%) required at least one transfusion. A gestational age less than 32 weeks and the presence of neonatal sepsis were factors associated with transfusions in this group of premature infants.…”