Title Anemija prematuriteta Title (english) Anemia of prematurity Author Sara Dugalić Mentor Nada Sindičić Dessardo (mentor)Committee member Ruža Grizelj (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Nada Sindičić Dessardo (član povjerenstva)Granter University of Zagreb Defense date and country 2023-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Anemija prematuriteta pojam je koji opisuje anemiju koja se najčešće opaža u nedonoščadi rođene prije 32. tjedna gestacije. Ovaj tip hipoproliferativne anemije se opisuje kao normocitna, normokromna i hiporegenerativna, s koncentracijama serumskog eritropoetina (EPO) značajno nižim od onih u odraslih sa sličnim stupnjem anemije. Također je karakterizira izostanak adekvatnog terapijskog odgovora na primjenu željeza, folata i vitamina E. U većine nedonoščadi anemija neće izazvati značajne liničke
... More simptome, međutim duboka anemija može biti praćena letargijom, tahikardijom ili bradikardijom, apnoičnim krizama, većom potrebom za kisikom, brzim umaranjem pri hranjenju, slabim prirastom na tjelesnoj masi te povišenim serumskim razinama laktata. Anemija prematuriteta je multifaktorijalna, ali ključni čimbenik za njen nastanak je oslabljen odgovor na EPO, koji u nedonoščeta ima kraći životni vijek te se brže metabolizira. Anemiji doprinose i kraći životni vijek eritrocita, hemodilucija zbog ubrzanog rasta i jatrogeni gubici krvi zbog prečestog uzorkovanja za dijagnostičke analize. Razlog zbog kojeg u nedonoščadi ne dolazi do porasta EPO kao odgovora na anemiju nije poznat. Međutim, eritroidne progenitorske stanice u koštanoj srži su visoko osjetljive na EPO, te su koncentracije ostalih eritropoetičnih faktora rasta odgovornih za produkciju eritrocita normalne. Primjena egzogenog EPOa u prevenciji anemije prematurita povezana je s boljim neurorazvojnim ishodom, kako zbog njegovih neuroprotektivnih svojstava tako i zbog rjeđe primjene transfuzije eritrocita. Odgođenim podvezivanjem pupkovine, kojim se osigurava dostatna placentarna transfuzija, može se odgoditi pojava i umanjiti intenzitet anemije. Iako primjena stimulatora eritropoeze i suplementacija željeza mogu smanjiti težinu anemije, implementacija strožih i standardiziranih kriterija za transfuziju uz minimalizaciju jatrogenih gubitka krvi imaju najznačajniji utjecaj u reduciranju potreba za transfuzijama, kako u nedonoščadi, tako i u terminske novorođenčadi. Less Abstract (english) The term "anemia of prematurity" is used to describe the pattern of anemia in preterm newborns, most commonly observed in infants born before 32 weeks of gestation. This type of hypoproliferative anemia is characterized as normocytic, normochromic, and hyporegenerative, with serum erythropoietin (EPO) concentrations significantly below those found in adults with similar degrees of anemia. This anemia is not responsive to the administration of iron, folate, or vitamin E. While some infants may
... More not show any symptoms, others may exhibit signs of anemia that can be alleviated by erythrocyte transfusion. These signs include lethargy, tachycardia or bradycardia, episodes of apnea, higher oxygen requirements, rapid tiring with nipple feeding, poor weight gain, and elevated serum lactate concentrations. Anemia of prematurity is multifactorial, but central to this condition is a blunted response to EPO, which, in the preterm newborn, has a shorter half-life and is metabolized faster. This is compounded by a shorter erythrocyte lifespan, hemodilution secondary to rapid growth, and the frequent need for blood tests to guide the provision of clinical care. The reason preterm infants do not significantly increase serum EPO concentration during this anemia is not known. However, marrow erythroid progenitors are highly sensitive to EPO, and concentrations of other erythropoietic growth factors responsible for erythrocyte production appear to be normal. The administration of exogenous EPO to prevent and treat the anemia of prematurity reveals a positive effect on decreased transfusion requirements in preterm infants, as well as beneficial neurodevelopmental effects. This condition is likely to be influenced by the practice of deferred cord clamping, which leads to higher initial Hb concentrations in preterm infants. While provision of adequate supplemental iron, and erythropoiesis-stimulating agents like EPO can potentially decrease the need for transfusion and exposure to donor blood in very preterm newborns, implementing more rigorous and standardized transfusion criteria or guidelines, along with minimizing blood loss from phlebotomy, may have the most significant impact in reducing transfusion requirements for both term and preterm infants. Less Keywords
anemija prematuriteta
eritropoetin
jatrogeni gubitak krvi
transfuzija
Keywords (english)
preterm newborn
anemia of prematurity
erythropoietin
phlebotomy
transfusion
Language croatian URN:NBN urn:nbn:hr:105:979962 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-10-24 09:32:46
