Uso de concentrado de hemacias em neonatologia : o panorama brasileiro

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The transfusion of Red Blood Cells (RBC) is often one of the therapeutical tools in advanced support in newborn intensive care units (NICU); the number of transfusions required depends on factors such as pregnancy duration and weight at birth. However, great variations are observed when comparing children in similar clinical conditions in different centers, as there are no controlled studies with established indications for newborn transfusion. Thus, the goal of the present study is to compare and describe the use of RBC transfusion through the qualitative and quantitative analysis of questionnaires in 42 services of NICUs in Brazil, focusing on its indications, repercussions and techniques; evaluating the presence and the adequacy of the protocols established from a scientific, descriptive, observational and longitudinal study. From this analysis, a more uniform protocol for the transfusion of RBC in Brazilian newborns is suggested. From the 42 hospital units studied, 20 are university hospitals, of which 17 are public institutions and 03 are private institutions. With respect to the service type, 26 units belong to SUS, 09 have private or insurance service and 07 work with both services (public and private). Furthermore, the institutions represent 4 regions of the country: 11 in the Northeast, 21 in the Southeast, 03 in Center-west and 07 in the South of Brazil; representing 670 NICU beds and 450 intermediate unit beds. The data collected was submitted to statistical analysis calculating the absolute and cumulative frequencies as well as the relative frequencies of each question of the applied questionnaires. No significant differences with respect to the use, preparation and indications were found when we analyzed private and educational institutions. However, the North and Northeast regions and the institutions geographically distant from the capitals, public services unrelated to universities have difficulty to access the hospital information, implementation and use of specific technologies. In the majority of the services, there is no interaction between the blood transfusion services and the NICUs; resulting in a difficult task for the professionals providing direct assistance. There are a large number of services that consider clinical parameters associated to the hemoglobin level (Hb) while others consider parameters associated to hematocrit (Hct) levels as a reference for the indication of transfusion of RBC. In conclusion, the decision of performing a transfusion in a patient must always be made by the leading doctor taking technical, medical, ethical and legal parameters into account, based on the use of protocols with more precise transfusion indications, adapted to the resources of each institution, in order to protect the patients from the risk of badly indicated transfusions

ASSUNTO(S)

sangue - transfusão neonatology neonatologia hemoterapia hemotherapy blood transfusion

ACESSO AO ARTIGO

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