| Abstrakt: |
Some of the more frequent adverse effects of transfusion that are seen in older children and adults, such as immunologically mediated febrile or allergic reactions, are rarely reported in the newborn. Neonates, however, are more vulnerable to metabolic complications and susceptible to potential toxic effects of various compounds as a result of the immature nature of their organ systems. Transfusion practices for neonates are continually changing as medical advances are made in the care of these critically ill newborns. Recent data shows that there is a decrease in overall administration of neonatal transfusions with most red blood cell (RBC) transfusions being given to infants who are less than 1000 g or extremely low birth weight (ELBW) infants [1],[2]. These ELBW infants often have major clinical problems as a result of their prematurity. Even though the use of surfactant has reduced the mortality from respiratory failure, the vast majority of infants will need some form of assisted ventilation requiring clinical monitoring [3]. A high percentage of infants will have cardiovascular problems in the form of a patent ductus arteriosus (PDA) that may require either medical or surgical treatment and careful fluid balance [4]. Fluid and electrolyte management is a challenge in these ELBW infants. As a result of the large surface area to body weight ratio and an underdeveloped epidermis evaporative losses can be significant. The immature kidney has limited concentrating ability providing a large amount of dilute urine. These infants therefore are vulnerable to dehydration and hyperosmolality, which may increase the risk for intraventricular hemorrhage (IVH) [4]. [ABSTRACT FROM AUTHOR] |
