Prematüre bebeklerde hemoglobin düzeyi ile bronkopulmoner displazi ilişkisi
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Date
2020-01-10
Authors
Varal, İpek Güney
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bronkopulmoner displazi (BPD) pretermlerde sık görülen bir kronik akciğer hastalığıdır. Bu çalışmada, farklı zamanlarda alınan kapiller hemoglobin (Hb) düzeyinin BPD gelişimi ile ilişkisini göstermek ve BPD gelişimini öngörmede bir belirteç olarak araştırılması hedeflendi. Retrospektif kohort tarzında düzenlenen çalışmaya hastanemiz yenidoğan ünitemizde yatan 32 gestasyon haftasının altında doğan preterm bebekler dahil edildi. Yatışı sırasında bronkopulmoner displazi tanısı alan hastalar grup 1, diğer hastalar grup 2 olmak üzere 2 grup belirlendi. Hastaların kapiller Hb düzeyleri doğdukları ilk gün,7. ve 14. günde olmak üzere toplam 3 kez kayıt edildi. BULGULAR: Çalışmaya 189 preterm bebek alınmış olup dışlanma kriterlerine göre değerlendirildikten sonra 65’i BPD, 93’ü BPD olmayan toplam 158 hasta dosyası incelemeye alındı. Grupların hemoglobin düzeyleri karşılaştırıldığında BPD gelişen grubun doğum hemoglobin ve 7. gün hemoglobin düzeylerinin anlamlı düzeyde daha düşük olduğu görüldü (p<0.05). Doğum kapiller Hb değeri için ROC analizi uygulandığında “cut-off” değeri 18mg/dl belirlendiğinde; bu değer için duyarlılık %55, özgüllük %66 ve AUC değeri 0.61 olarak saptandı (p < 0.05). Yedinci gün kapiller Hb değeri için ROC analizi uygulandığında “cut-off” değeri 16.3 mg/dl belirlendiğinde; bu değer için duyarlılık %86, özgüllük %51 ve AUC değeri 0.74 olarak saptandı (p<0.05). Biz bu çalışmada doğumda ve 7. günde ölçülen Hb seviyesi düşük olan pretermlerde BPD gelişiminin daha fazla olduğunu gözlemledik. Böylece Hb seviyesinin farklı mekanizmalarla akciğer dinamiklerine ve solunum sistemine etkisi olabileceğini değerlendirdik. Tüm bunlar sonucunda, yaşamın ilk günlerindeki Hb düzeyi ile risk altındaki bebekler erken tespit edilerek, erken koruyucu tedaviler için değerlendirilebilir.
Bronchopulmonary dysplasia (BPD) is a common preterm chronic lung disease. Objective of the study was to investigate relationship of BPD and hemoglobin (Hb) concentrations in preterms. : In this retrospective cohort study, preterm infants <32weeks followed in our neonatal intensive care unit were included. Patients diagnosed as BPD were categorized as group 1 where others were as group 2. Capillary Hb levels were collected at 1st, 7th and 14th day of their life. : A total of 189 preterm infants were assessed according to exclusion criteria and 158 of them were investigated as 65 of them BPD and 93 of them non-BPD. In comparison of groups’ Hb concentrations, relationship was significant between 1st day and 7th day Hb concentrations of the BPD group (p<0.05). ROC analysis indicated that AUC of 1st day capillary Hb was 0.61 (p<0.05) and cut-off point optimized for sensitivity 55% and specificity %66 was determined as Hb level of 18mg/dl. ROC analysis indicated that AUC of 7st day Hb was 0.74 (p<0.05) and cut-off point optimized for sensitivity 86% and specificity 51% was determined as capillary Hb level of 16.3mg/dl (p<0.05). : In this study, we observed that BPD development was higher in patients with low Hb concentrations measured at 1st and 7th days. We considered that Hb concentration might affect lung dynamics and respiratory system by means of different mechanisms. In conclusion, early preventive treatment might be started as determination of risky patients using the Hb concentrations at first days of life.
Bronchopulmonary dysplasia (BPD) is a common preterm chronic lung disease. Objective of the study was to investigate relationship of BPD and hemoglobin (Hb) concentrations in preterms. : In this retrospective cohort study, preterm infants <32weeks followed in our neonatal intensive care unit were included. Patients diagnosed as BPD were categorized as group 1 where others were as group 2. Capillary Hb levels were collected at 1st, 7th and 14th day of their life. : A total of 189 preterm infants were assessed according to exclusion criteria and 158 of them were investigated as 65 of them BPD and 93 of them non-BPD. In comparison of groups’ Hb concentrations, relationship was significant between 1st day and 7th day Hb concentrations of the BPD group (p<0.05). ROC analysis indicated that AUC of 1st day capillary Hb was 0.61 (p<0.05) and cut-off point optimized for sensitivity 55% and specificity %66 was determined as Hb level of 18mg/dl. ROC analysis indicated that AUC of 7st day Hb was 0.74 (p<0.05) and cut-off point optimized for sensitivity 86% and specificity 51% was determined as capillary Hb level of 16.3mg/dl (p<0.05). : In this study, we observed that BPD development was higher in patients with low Hb concentrations measured at 1st and 7th days. We considered that Hb concentration might affect lung dynamics and respiratory system by means of different mechanisms. In conclusion, early preventive treatment might be started as determination of risky patients using the Hb concentrations at first days of life.
Description
Keywords
Bronkopulmoner displazi, Preterm, Bronchopulmonary dysplasia, Hemoglobin
Citation
Varal, İ.G. (2020). "Prematüre bebeklerde hemoglobin düzeyi ile bronkopulmoner displazi ilişkisi". Güncel Pediatri Dergisi, 18(1), 15-28