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Blood transfusion and neonate

Gregory J Kato, Frédéric B Piel, Clarice D Reid, Marilyn H Gaston, Kwaku Ohene-Frempong, Lakshmanan Krishnamurti, Wally R Smith, Julie A Panepinto, David J Weatherall, Fernando F Costa, Elliott P Vichinsky
Sickle cell disease (SCD) is a group of inherited disorders caused by mutations in HBB, which encodes haemoglobin subunit β. The incidence is estimated to be between 300,000 and 400,000 neonates globally each year, the majority in sub-Saharan Africa. Haemoglobin molecules that include mutant sickle β-globin subunits can polymerize; erythrocytes that contain mostly haemoglobin polymers assume a sickled form and are prone to haemolysis. Other pathophysiological mechanisms that contribute to the SCD phenotype are vaso-occlusion and activation of the immune system...
March 15, 2018: Nature Reviews. Disease Primers
Guo-Jin Ou, Pin-Can Su, Hao Yu, Xin Ji, Fan Liu, Sheng-Lan Wang, Yu-Jie Kong, Ling Li, Jue Wang, Zhong Liu, Willy Albert Flegel
BACKGROUND: Human neutrophil antigen 3 (HNA-3) is encoded by the SLC44A2 gene. Antibodies against HNAs can cause severe, often fatal, transfusion reactions, known as transfusion-related acute lung injury, and neonatal neutropenia. We explored the 2 common HNA-3 variants in 9 ethnic populations residing in Sichuan and Yunnan provinces of China as compared to the Han population. METHODS: We genotyped for SLC44A2 (rs2288904) by polymerase chain reaction sequence-based typing among blood donors, for a total of 2206 individuals in Yunnan and 376 in Sichuan...
March 14, 2018: Journal of Translational Medicine
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
Nariaki Asada
Kidneys are physiologically hypoxic due to huge oxygen consumption for tubular reabsorption. The physiological hypoxia makes the kidney an appropriate organ for sensitively detecting oxygen levels and producing erythropoietin (EPO). In preterm neonates, immature kidneys cannot produce sufficient EPO, which results in anemia of prematurity (AOP). The cause of EPO insufficiency in AOP has been unclear, therefore current therapeutic options are transfusion and injection of recombinant human EPO. This report shows that the cause of insufficient EPO production in AOP is elevated renal oxygen levels due to poor oxygen consumption by immature tubules...
March 13, 2018: Scientific Reports
Ahmet Yagmur Bas, Nihal Demirel, Esin Koc, Dilek Ulubas Isik, İbrahim Murat Hirfanoglu, Turan Tunc
BACKGROUND: To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. METHODS: A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study...
March 8, 2018: British Journal of Ophthalmology
Michael P Meyer, Elizabeth Nevill, Maisie M Wong
BACKGROUND: Placental transfusion (by means of delayed cord clamping (DCC), cord milking, or cord stripping) confers benefits for preterm infants. It is not known if providing respiratory support to preterm infants before cord clamping improves outcomes. OBJECTIVES: To assess the efficacy and safety of respiratory support provided during DCC compared with no respiratory support during placental transfusion (in the form of DCC, milking, or stripping) in preterm infants immediately after delivery...
March 8, 2018: Cochrane Database of Systematic Reviews
Huijing Zhang, Ruochong Dou, Huixia Yang, Xianlan Zhao, Dunjin Chen, Yilin Ding, Hongjuan Ding, Shihong Cui, Weishe Zhang, Hong Xin, Weirong Gu, Yali Hu, Guifeng Ding, Hongbo Qi, Ling Fan, Yuyan Ma, Junli Lu, Yue Yang, Li Lin, Xiucui Luo, Xiaohong Zhang, Shangrong Fan
OBJECTIVE: The objective of this study is to identify the maternal and neonatal outcomes in women with placenta increta or placenta percreta in China. MATERIALS AND METHODS: We retrospectively analyzed 2219 cases from 20 tertiary care centers in China between January 2011 and December 2015. All cases were diagnosed of placenta increta or placenta percreta, based on either intraoperative findings or histopathological findings. RESULTS: The incidence of placenta increta and placenta percreta progressively increased from 0...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
Thanh-Vy Phung, Véronique Houfflin-Debarge, Nassima Ramdane, Louise Ghesquière, Anne Delsalle, Capucine Coulon, Damien Subtil, Pascal Vaast, Charles Garabedian
BACKGROUND: The antibody primarily responsible for fetal anemia may influence treatment and prognosis. The primary objective was to compare ante- and postnatal management and the outcomes of maternal red blood cell (RBC) alloimmunizations according to the antibody involved. The secondary objective was to compare anti-D alloimmunizations according to associated number of antibodies. STUDY DESIGN AND METHODS: A single-center study from 1999 to 2015 including maternal RBC alloimmunizations requiring intrauterine transfusion (IUT) was conducted...
March 6, 2018: Transfusion
Víctor Lago Leal, Loida Pamplona Bueno, Lucía Cabanillas Vilaplana, Estefanía Nicolás Montero, Mónica Martín Blanco, Cristina Fernández Romero, Sara El Bakkali, Tamara Pradillo Aramendi, Lara Sobrino Lorenzano, Paula Castellano Esparza, Esther Ballesteros Benito, Nieves Rayo Navarro, Pablo Del Barrio Fernández, Vanesa Ocaña Martínez, Luis Martínez Cortés
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0...
March 5, 2018: Fetal Diagnosis and Therapy
Rajiv R Iyer, Carolyn M Carey, S Alex Rottgers, Lisa Tetreault, Ccrp, Nir Shimony, Jennifer Katzenstein, Ernesto Ruas, Gerald F Tuite
OBJECTIVE Infants with severe hydrocephalus and extreme macrocephaly typically undergo CSF diversion early in life, which can result in significant cranial deformity due to CSF overdrainage. In this scenario, overlap of the cranial plates can precede the development of secondary synostosis and/or severe, permanent cranial deformity. As a result, extensive cranial vault remodeling is sometimes undertaken later in life, which is often challenging and has been associated with mortality and a high morbidity rate...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Shaun Lawicki, Emily A Coberly, Laura A Lee, Mary Johnson, Quentin Eichbaum
BACKGROUND: The Kidd-null phenotype, Jk(a-b-), occurs in individuals who do not express the JK glycoprotein. Jk(a-b-) individuals can make an antibody against the Jk3 antigen, a high-incidence antigen present in more than 99.9% of most populations. This presents many challenges to the blood bank including identification of the antibody, masking of other antibodies, and how to provide transfusion support given the rarity of Jk3-negative blood products. Kidd antibodies may cause acute and delayed hemolytic reactions as well as hemolytic disease of the fetus and newborn (HDFN)...
February 25, 2018: Transfusion
Jillian A Patterson, Jennifer R Bowen, Sally Francis, Jane B Ford
BACKGROUND: Infants in Neonatal Intensive Care Units represent a heavily transfused population, and are the focus of much research interest. Such research commonly relies on custom research databases or routinely collected data. Knowledge of the accuracy of transfusion recording in these databases is important. This study aims to assess the reporting of red blood cell transfusion neonatal intensive care unit data compared with routinely collected hospital blood bank ("Blood Watch") data...
February 23, 2018: BMC Pediatrics
Omer Erdeve, Emel Okulu, Ozgur Olukman, Dilek Ulubas, Gokhan Buyukkale, Fatma Narter, Gaffari Tunc, Begum Atasay, Nazli Dilay Gultekin, Saadet Arsan, Esin Koc
BACKGROUND: Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. METHODS: A multicenter prospective study was conducted on otherwise healthy newborns born at ≥35 weeks of gestation and hospitalized for only NNJ in 50 collaborator neonatal intensive care units across Turkey over a 1-year period...
2018: PloS One
Aaron R J Hutton, Helen L Quinn, Paul J McCague, Courtney Jarrahian, Annie Rein-Weston, Patricia S Coffey, Emily Gerth-Guyette, Darin Zehrung, Eneko Larrañeta, Ryan F Donnelly
Vitamin K deficiency within neonates can result in vitamin K deficiency bleeding. Ensuring that newborns receive vitamin K is particularly critical in places where access to health care and blood products and transfusions is limited. The World Health Organization recommends that newborns receive a 1 mg intramuscular injection of vitamin K at birth. Evidence from multiple surveillance studies shows that the introduction of vitamin K prophylaxis reduces the incidence of vitamin K deficiency bleeding. Despite these recommendations, coverage of vitamin K prophylactic treatment in low-resource settings is limited...
February 19, 2018: International Journal of Pharmaceutics
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
Itamar Nitzan, Cathy Hammerman, Francis B Mimouni, Alona Bin-Nun
OBJECTIVE: To assess the effect of blood transfusions in neonates on partial pressure of oxygen in arterial blood (PaO2 ), arterial hemoglobin oxygen saturation (SaO2 ) and arterial hemoglobin oxygen saturation as measured by pulse oximetry (SpO2 ). STUDY DESIGN: Retrospective study of neonates that received a first blood transfusion while having an indwelling arterial line. We compared PaO2 , SaO2, SpO2, SaO2 /PaO2 ratio and fraction of inspired oxygen (FiO2 ) 12 h before and after blood transfusion...
February 21, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Ranit Hizkiyahu, Anat Rabinovich, Jecko Thachil, Eyal Sheiner, Gad Shaked, Gilbert Sebbag, Eli Maymon, Offer Erez
OBJECTIVES: Liver rupture and hematoma are rare life-threatening complications of pregnancy. The aims of the current study are to: (1) characterize in a population-based study all cases of liver hematoma and/or rupture; and (2) validate the utility of the International Society on Thrombosis and Haemostasis (ISTH) modified pregnancy specific disseminated intravascular coagulation (DIC) score in those cases. STUDY DESIGN: A retrospective cohort study including all patients with liver subcapsular hematoma or rupture between the years 1996 and 2012 was conducted...
February 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
February 5, 2018: Pediatric Critical Care Medicine
V R Ravikumar, G Rajamani, Vijayakumar Raju, Rajani Sundar, Sowmya Ravikumar, Raghul Maniam
A 7-day-old neonate presented with a large intra-abdominal mass adherent to the hilum of the liver encasing the portal triad. During excision, the portal vein, hepatic artery, and common bile duct were injured. The repair was done promptly and needed massive blood transfusion. Histopathology revealed immature teratoma Grade III. Survival in neonate following total transection of portal triad is rare and has not been reported.
January 2018: Journal of Indian Association of Pediatric Surgeons
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