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Background: Neonatal apnea is frequently encountered in Very low birth
weight (VLBW) babies contributing to death and disability. Apart from
conventional treatment many centres developed transfusion guideline
with conflicting result.
Objective: To determine the effect of transfusion or infusion on apneic
newborn and also to evaluate other effects like weight gain and course
of illness.
Methods: A prospective observational study was carried out in the
neonatal unit of Khulna Medical College Hospital from July 2013 to June
2014. Inclusion criteria were VLBW newborn with apnea. Apneic patients
were divided into two equal groups. Traditional group got the
conventional treatment with methylxanthin and positive pressure
ventilation. The intervention group, in addition, received either packed
cell or protein solution depending on the haemoglobin level. Progress of
the patient was monitored daily in terms of heart rate, respiratory rate,
apnea and oxygen saturation. Main outcome measures were the
difference in mortality, morbidity and weight gain with or without
intervention.
Results: Out of 1682 newborn admitted during the study period, 235 (14%)
were VLBW. Majority (62.9%) of them were attributed to combined
prematurity and IUGR. Out of 48 in the intervention group, 9 and 18
babies received packed cell and protein solutions respectively, while 21
babies received both packed cell and protein solution. Death from
apnea was lower in the intervention group than traditional group but it
was not statistically significant (p=0.237). However, mean weight gain
(gm/kg/day) was significantly higher (14.3 Vs 11.5, p=0.016) with
transfusion. Only two patients developed complications and one of them
died.
Conclusion: Transfusion of packed cell or infusion of protein solution has
little impact on apnea of newborn. However transfusion/infusion has
positive association with weight gain.
Choudhury Habibur Rasul , F Ahammad, T Islam, S Shoyeb. (2016) Impact of Transfusion in Apneic Newborn with Prematurity and Growth Retardation, Pakistan Pediatric Journal, Volume 40, Issue 3.
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