Çocuk yoğun bakım ünitesinde yatan hastalarda iyatrojenik anemi sıklığı ve risk belirteçleri
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Tarih
2024
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Selçuk Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Anemi çocuk yoğun bakım ünitesinde yatan kritik hastalarda çok yaygın bir sorundur. Biz bu çalışmada çocuk yoğun bakım ünitesinde yatan hastalarda iyatrojenik anemi sıklığını, ciddi hastalık gruplarında aneminin önemini, taburculuk süresine etkisini ve aneminin risk faktörlerini belirlemeyi amaçladık. Gereç ve yöntemler: Selçuk Üniversitesi Tıp Fakültesi Hastanesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı 3. Basamak Çocuk Yoğun Bakım Ünitesi'nde 1 Ocak 2022 ve 31 Aralık 2022 tarihleri arasında takip ve tedavi edilen 155 hasta çalışmaya dahil edildi. Bu hastaların dosyaları geriye dönük olarak taranarak hastaların demografik verileri, takipteki hemoglobin ve diğer laboratuvar değerleri, anemik hemoglobin değerine kaçıncı günde vardıkları, tranfüzyon öncesi ve sonrası hemoglobin değerleri, yatış nedenleri, yatış süreleri, mekanik ventilatörde kalma süreleri, yatıştaki beslenme şekilleri (parenteral / enteral), inotrop desteği alıp almadıkları kaydedildi. İstatistiksel analizler SPSS (Statistical Package for Social Sciences) for Windows 22.0 programı kullanılarak yapıldı. Bulgular: Hastaların 96'sı (%61,9) erkek, 59'u (%38,1) kız idi. Yaş ortalaması 53,77±60 ay idi. Hastaların yoğun bakıma yatıştaki ortalama hemoglobin değeri 11,14±2,12 g/dL idi. Hastaların %47,7'sinde iyatrojenik anemi gelişti. Ortalama iyatrojenik anemi gelişme süresi 4,36±3,13 gün idi. İyatrojenik anemi gelişenlerin gelişmeyenlere kıyasla yoğun bakım kalış sürelerinin istatiksel olarak anlamlı daha fazla olduğu (p=0,008) görüldü ancak mekanik ventilasyonda kalma süreleri arasındaki fark istatiksel olarak anlamlı değildi (p=0,131). İyatrojenik anemi gelişenlerde gelişmeyenlere kıyasla istatiksel olarak daha fazla transfüzyon yapıldığı (p=0,001) ve transfüzyon sayısının (p=0,035) da istatiksel olarak anlamlı daha fazla olduğu saptandı. Hastaların 53'üne (%34,2) ES tansfüzyonu uygulandı. Transfüzyon yapılan hastalarda mortaliteleri (p=0,001), mekanik ventilasyon süreleri (p<0,001) ve yoğun bakımda kalış süreleri (p<0,001) transfüzyon yapılmayan hastalardan istatiksel olarak anlamlı daha yüksekti (p< 0,001). Sonuç: Sonuç olarak çocuk yoğun bakım ünitesinde yatan hastalarda görülen anemi sıklığı az değildir ve bunun sonucunda yapılan transfüzyonlar mortalite ile ilişkilendirilmiştir. Tetkik amaçlı kan almak kaçınılmaz olabilir ancak iyatrojenik aneminin nelere sebep olabileceği iyi bilinilirse gereksiz tahlillerden kaçınılarak gereksiz transfüzyonların azaltılması sağlanabilir.
Objective: Anemia is a very common problem in critically ill patients hospitalized in the pediatric intensive care unit. In this study, we aimed to determine the frequency of iatrogenic anemia in pediatric intensive care unit patients, the importance of anemia in serious disease groups, its effect on discharge time and risk factors of anemia. Materials and methods: 155 patients who were followed up and treated in the 3rd Level Pediatric Intensive Care Unit of the Department of Pediatrics, Faculty of Medicine Hospital, Selçuk University, were included in the study between January 1, 2022, and December 31, 2022. The files of these patients were retrospectively scanned, and the following data were recorded: demographic information of the patients, hemoglobin and other laboratory values during follow-up, the day on which they reached the anemic hemoglobin value, hemoglobin values before and after transfusion, reasons for admission, length of stay, duration of mechanical ventilation, methods of nutrition during admission (parenteral/enteral), and whether they received inotropic support. Statistical analyses were conducted using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. Results: Of the patients, 96 (61.9%) were male, and 59 (38.1%) were female. The mean age was 53.77±60 months. The mean hemoglobin value upon admission to the intensive care unit was 11.14±2.12 g/dL for the patients. In 47.7% of the patients, iatrogenic anemia developed. It was observed that the intensive care unit stay duration was statistically significantly longer (p=0.008) in those who developed iatrogenic anemia compared to those who did not develop it, however, the difference in the duration of mechanical ventilation was not statistically significant (p=0.131). It was determined that statistically significantly more transfusions were performed (p=0.001) in those who developed iatrogenic anemia compared to those who did not develop it, and the number of transfusions was also statistically significantly higher (p=0.035). Erythrocyte suspension (ES) transfusion was administered to 53 patients (34.2%). In patients who received transfusions, their mortality rate (p=0.001), duration of mechanical ventilation (p<0.001), and length of stay in the intensive care unit (p<0.001) were statistically significantly higher compared to patients who did not receive transfusions (p<0.001). Conclusion: As a result, anemia is not uncommon among patients admitted to the pediatric intensive care unit, and transfusions performed as a result have been associated with mortality. While taking blood samples for investigation purposes may be unavoidable, awareness of the potential consequences of iatrogenic anemia can help reduce unnecessary tests and unnecessary transfusions.
Objective: Anemia is a very common problem in critically ill patients hospitalized in the pediatric intensive care unit. In this study, we aimed to determine the frequency of iatrogenic anemia in pediatric intensive care unit patients, the importance of anemia in serious disease groups, its effect on discharge time and risk factors of anemia. Materials and methods: 155 patients who were followed up and treated in the 3rd Level Pediatric Intensive Care Unit of the Department of Pediatrics, Faculty of Medicine Hospital, Selçuk University, were included in the study between January 1, 2022, and December 31, 2022. The files of these patients were retrospectively scanned, and the following data were recorded: demographic information of the patients, hemoglobin and other laboratory values during follow-up, the day on which they reached the anemic hemoglobin value, hemoglobin values before and after transfusion, reasons for admission, length of stay, duration of mechanical ventilation, methods of nutrition during admission (parenteral/enteral), and whether they received inotropic support. Statistical analyses were conducted using the SPSS (Statistical Package for Social Sciences) for Windows 22.0 program. Results: Of the patients, 96 (61.9%) were male, and 59 (38.1%) were female. The mean age was 53.77±60 months. The mean hemoglobin value upon admission to the intensive care unit was 11.14±2.12 g/dL for the patients. In 47.7% of the patients, iatrogenic anemia developed. It was observed that the intensive care unit stay duration was statistically significantly longer (p=0.008) in those who developed iatrogenic anemia compared to those who did not develop it, however, the difference in the duration of mechanical ventilation was not statistically significant (p=0.131). It was determined that statistically significantly more transfusions were performed (p=0.001) in those who developed iatrogenic anemia compared to those who did not develop it, and the number of transfusions was also statistically significantly higher (p=0.035). Erythrocyte suspension (ES) transfusion was administered to 53 patients (34.2%). In patients who received transfusions, their mortality rate (p=0.001), duration of mechanical ventilation (p<0.001), and length of stay in the intensive care unit (p<0.001) were statistically significantly higher compared to patients who did not receive transfusions (p<0.001). Conclusion: As a result, anemia is not uncommon among patients admitted to the pediatric intensive care unit, and transfusions performed as a result have been associated with mortality. While taking blood samples for investigation purposes may be unavoidable, awareness of the potential consequences of iatrogenic anemia can help reduce unnecessary tests and unnecessary transfusions.
Açıklama
Anahtar Kelimeler
Çocuk Yoğun Bakım Ünitesi, İyatrojenik Anemi, Transfüzyon, Mortalite, Pediatric Intensive Care Unit, Iatrogenic Anemia, Transfusion, Mortality
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Işık Bedir, Ş. (2024). Çocuk yoğun bakım ünitesinde yatan hastalarda iyatrojenik anemi sıklığı ve risk belirteçleri. (Uzmanlık Tezi). Selçuk Üniversitesi, Tıp Fakültesi, Konya.
