Critical haemoglobin thresholds in premature infants

Andersen, Chad

doi:10.1136/fn.84.3.f146

Cited by 11 publications

(8 citation statements)

References 32 publications

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“…The critical hematocrit thresholds to trigger RBCT remain difficult to establish in premature infants [36] . Whereas most reports over the past decade have suggested that RBCT can be safely reduced, a recent randomized trial showed a higher risk of severe adverse neurologic events associated with a restrictive use of RBCT [37] .…”

Section: Discussionmentioning

confidence: 99%

Myocardial Adaptation to Anemia and Red Blood Cell Transfusion in Premature Infants Requiring Ventilation Support in the 1st Postnatal Week

Cambonie

Matecki²,

Milési³

et al. 2007

Neonatology

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Background: Although transfusion practice in very premature infants is becoming more restrictive, little is known about myocardial adaptation to anemia during the 1st postnatal week. Objectives: To determine the central hemodynamic effects of anemia and red blood cell transfusion in very preterm infants undergoing intensive care. Methods: Twenty-nine neonates of less than 30 weeks gestational age were treated for respiratory distress syndrome, following a strict protocol. Echocardiographies were performed at the 4th and 6th postnatal days, which corresponded to, respectively, just before and 48 h after an erythrocyte transfusion of 15 ml/kg in the 12 anemic infants. Results: Anemic infants had increased stroke volume [2.1 (1.8–2.3) vs. 1.5 (1.3–1.6) ml/kg] and left ventricular (LV) output [312 (271–345) vs. 206 (177–240) ml/min/kg]. The relationship of the heart rate-corrected velocity of circumferential fiber shortening to LV end-systolic meridional wall stress indicated a higher contractile state in the anemic infants, with a higher y-intercept (p = 0.03) and a steeper slope (p = 0.05) of the regression line than in the nonanemic patients. Posttransfusion, the stroke volume, LV output, shortening fraction, and contractile state decreased to the values observed in the nonanemic infants. Conclusions: Myocardial contractility was a major component of the circulatory adjustments in the anemic premature infants requiring ventilation support in the early neonatal period. Changes in LV performance associated with anemia were reversed by transfusion with no detrimental effect on right ventricular function, LV preload or the respiratory status of these patients.

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Section: Discussionmentioning

confidence: 99%

Myocardial Adaptation to Anemia and Red Blood Cell Transfusion in Premature Infants Requiring Ventilation Support in the 1st Postnatal Week

Cambonie

Matecki²,

Milési³

et al. 2007

Neonatology

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“…The arterial oxygen content is determined by hemoglobin concentration, oxygen carrying capacity, oxygen saturation, and PaO 2 . 10 Thus, arterial blood pressure and hemoglobin are the key factors in systemic oxygen transport.…”

Section: Discussionmentioning

confidence: 99%

“…Intraventricular hemorrhage (IVH) was diagnosed on serial cranial ultrasound and was graded I -IV according to the Papille classifi cation. 10 The diagnosis of patent ductus arteriosus (PDA) was determined by both clinical symptoms and the presence of PDA fl ow on color Doppler echocardiography.…”

Section: Methodsmentioning

confidence: 99%

Predictive factors for survival for out‐born infants born between 23 and 24 weeks of gestation in the post‐surfactant era: Fourteen years’ experience in a single neonatal care unit, 1987–2000

Hosono

Ohno

Kimoto

et al. 2008

Pediatrics International

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“…Pada umur 2 bulan rerata kadar hemoglobin dapat mencapai 9,5 mg/dL pada bayi dengan berat badan lahir antara 1500 sampai 2000 gram dan 9,0 mg/dL pada bayi dengan berat badan lahir 1000 sampai 1500 gram. 9,13 Tata laksana bayi anemia prematuritas meliputi transfusi darah, suplemen besi dan terapi eritropoetin rekombinan. Pemberian trasfusi darah tergantung dari berbagai faktor, di antaranya adalah kadar hemoglobin, keadaan kardiorespirasi, gejala dan tanda anemia.…”

Section: Penggunaan Eritropoetin Pada Anemia Prematuritasunclassified

Peran Eritropoetin pada Anemia Prematuritas

Sartika

Retayasa

Kardana

et al. 2016

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Eritropoetin merupakan molekul glikoprotein yang terdiri dari 165 asam amino dan 4 gugus karbohidrat dengan berat molekul sekitar 34 k dalton. Peran eritropoetin dalam produksi sel darah merah melalui meningkatkan survival, proliferasi dan diferensiasi dari progenitor eritroid pada sumsum tulang. Eritropoetin berikatan dengan reseptor selanjutnya terjadi aktivasi ras/mitogen intraselular yang berperan dalam proliferasi sel. Regulasi produksi eritropoetin adalah peran dari hypoxia-inducible transcription factor-1 (HIF-1). Pada bayi yang lahir prematur terjadi penurunan kadar Hb yang berlebihan dibandingkan dengan bayi cukup bulan. Banyak faktor yang mempengaruhi anemia prematuritas, salah satu di antaranya adalah kurang respon eritropoetin terhadap penurunan kadar Hb. Penggunaan eritropoetin rekombinan mengurangi frekuensi transfusi darah dan meningkatkan retikulosit dengan cepat. Eritropoetin rekombinan belum merupakan standar pengobatan anemia prematuritas secara universal (Sari Pediatri 2008;9(6):375-80). Eritropoetin merupakan faktor pertumbuhan hematopoetik pertama yang dapat dibuat, yaitu eritropoetin rekombinan (epoetin alfa).4 Bersama dengan kemajuan teknologi DNA, eritropoetin rekombinan yang baru telah ditemukan yaitu Darbepoetin-α (NESP). Darbepoetin-α sedikit berbeda dengan eritropoetin aslinya. Darbepoetin-α memiliki berat molekul 38,5 k dalton, 5 rantai ikatan dengan oligosakarida dibandingkan 3 rantai oligosakarida pada eritropoetin aslinya, total karbohidrat 52% dibandingkan 40% pada eritropoetin yang asli, mempunyai waktu paruh yang lebih panjang yaitu sekitar 48,8 jam dibandingkan 12-48 jam pada pemberian secara subkutan. Sedangkan ikatan reseptor pada tempat bekerja eritropoetin sama dengan eritropoetin asli. 2Pada tikus diperlukan sekitar 0,4 IU eritropoetin perhari untuk mempertahankan pruduksi sel darah merah, sedangkan pada manusia belum diketahui. Pada anemia atau hipoksia terjadi peningkatan kadar

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Critical haemoglobin thresholds in premature infants

Cited by 11 publications

References 32 publications

Myocardial Adaptation to Anemia and Red Blood Cell Transfusion in Premature Infants Requiring Ventilation Support in the 1st Postnatal Week

Myocardial Adaptation to Anemia and Red Blood Cell Transfusion in Premature Infants Requiring Ventilation Support in the 1st Postnatal Week

Predictive factors for survival for out‐born infants born between 23 and 24 weeks of gestation in the post‐surfactant era: Fourteen years’ experience in a single neonatal care unit, 1987–2000

Peran Eritropoetin pada Anemia Prematuritas

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