Abstract

Objective: The blood volume in the newborn is 85 cc/kg and there is a decrease in hemoglobin/hematocrit values in surgical newborns due to both the operation and blood sampling. This study aimed to determine the decrease in hemoglobin/hematocrit values as a result of blood sampling for tests performed during hospitalization in the surgical neonatal intensive care unit.

Method: This retrospective study is planned in newborns who were operated and stayed in the hospital for more than fifteen days in the last year. The demographic characteristics of the patients, the number and amount of blood sampling, hemoglobin/hematocrit values, the number and quantity of erythrocyte transfusions, and the amount of other blood product transfusions were evaluated. The data were analyzed in SPSS program.

Results: There were 27 cases of whom 55.6% were girls and 44.4% were boys. The gestational weeks were 37±3w (31w-41w) and birth weight was 2779±670 gr (1410 gr-3765 gr), retrospectively. The diagnoses were esophageal atresia+TEF (11 patients), intestinal obstruction (7 patients), genitourinary pathologies (3 patients), omphalocele (2 patients), intestinal perforation (2 patients), diaphragmatic hernia (1 patient), pyloric stenosis (1 patient) ), congenital cystic adenoid malformation (1 patient). The length of hospital stay was 20.7±7.2 days (15 days-38 days); noninvasive-mechanical ventilation time was 6±4.8 days (1-16 days), and invasive-mechanical ventilation time was 8.2±6.15 days (1-25 days). Invasive mechanical ventilation was not used in 51.9% (14 patients). The first hematocrit/hemoglobin values of the patients were 47.9%/16.3 mg/dl (27.5%/9.08- 64.5%/22.1 mg/dl), the final hematocrit/ hemoglobin values were 38.25%/It was 12.98 mg/dl (24.7%/8.1- 55.4%/19 mg/dl). The blood sampling number was 17.9±6.55 and the amount of blood sample was 17.35±6.16 ml (9-31 ml). The blood sampling amounts were 8% (3.9% -15.9%) according to the total body blood volume. Erithrocyte transfusion was performed in 25.9% of 27 patients and fresh frozen plasma transfusion in 26.7%. There was a statistically significant relationship between the number of phlebotomies and amount of hospitalization periods (p=0.016), need for noninvasive mechanical ventilation (p=0.046) and need for invasive mechanical ventilation (p=0.026).

Conclusion: In the intensive care units, the number of phlebotomies can be minimized by developing laboratory devices that work with micro-tube use/micro sampling methods to reduce iatrogenic blood loss through phlebotomy, as well as regular and accurate management of patient monitoring.

Atıf vermek için: Devrim Ayvaz O, Celayir A. Cerrahi yenidoğanlarda Flebotomi ile iyatrojenik anemi hipovolemi ve kan ve kan ürünleri transfüzyon gereksinimi. Çoc. Cer. Derg. 2020;34(1):19-23.

Bu çalışma 36. Ulusal Çocuk Cerrahisi Kongresi ve 3. Uluslararası Pediatrik Endoskopik Cerrahi Grubu - Ortadoğu Bölümü kongresinde sunulmuştur.