Trombosit Kitle İndeksi Yenidoğanın Geçici Takipnesi Tanılı Geç Preterm Bebeklerin Solunum Destek Süresini Öngörebilir mi?
Abstract
Amaç: Yenidoğanın geçici takipnesi (YDGT), yenidoğan yoğun bakımda çalışan hekimlerin en sık karşılaştığı solunumsal problem olup geç preterm bebeklerde görülme oranları, term bebeklere göre daha yüksektir. Trombositler, tam olarak bilinmeyen bir mekanizma ile akciğerde sıvı toplanmasını ve akciğer ödemini engeller. Trombositin fonksiyonu, sadece MPV (ortalama trombosit hacmi) ya da sadece trombosit sayısından ziyade, trombosit kitle indeksi ile daha doğru olarak değerlendirilebilir. Çalışmamızda, YDGT tanılı geç preterm bebeklerde sonunum destek ihtiyacı süresini ve diğer solunumsal sonlanımları ile PMI (trombosit kitle indeksi) başta olmak üzere trombosit belirteçlerinin ilişkisinin araştırılması planlanmıştır.
Gereçler ve Yöntem: Bu retrospektif çalışmada, 1 Ağustos 2020-31Temmuz 2021 tarihleri arasında, YDGT tanısı ile Buca Seyfi Demirsoy Eğitim ve Araştırma Hastanesi yenidoğan yoğun bakım ünitesinde yatırılmış, takipnesi en az 12 saat sürmüş tüm geç preterm yenidoğanlara ait veriler hastane kayıtlarından incelendi. Bebeklerin trombosit belirteçleri, lökosit ve nötrofil değerleri ile solunum destek süreleri karşılaştırıldı. Ayrıca bu parametreler, gestasyonel haftalara göre olası farklılıklar açısından değerlendirildi.
Bulgular: Çalışmaya 52 bebek dahil edildi. Gestasyonel hafta ortancası 35 hafta (34-366/7), ortalama doğum ağırlıkları 2647474 idi. Bebeklerin toplam solunum destek süreleri ya da >48 saat solunum desteği almaları ile trombosit sayısı, MPV, PMI, lökosit ve absolut nötrofil sayısı (ANS) ile ilişkili saptanmadı. Ancak 72 saatten fazla solunum desteği alan bebeklerde PMI değerlerinin daha düşük olduğu ve bunun da istatistiksel olarak anlamlı olduğu görüldü. Ayrıca MPV değerinin 35.gestasyon haftasında, ANS değerinin ise 36. gestasyon haftasında doğan bebeklerde anlamlı olarak yüksek olduğu görüldü.
Sonuç: Çalışmamızda, trombosit belirteçlerinden, PMI’nın, YDGT tanılı geç preterm bebeklerin 72 saatten uzun süre solunum desteği almaları ile ilişkili olduğu, bu bebeklerin ortalama PMI değerlerinin daha düşük olduğu görülmüştür. Ancak benzer bir ilişki diğer trombosit belirteçleri ile solunum destek süresi arasında saptanmamıştır.
Keywords
Trombosit kitle indeksi yenidoğan geçici takipne geç preterm trombosit ortalama trombosit hacmi
Supporting Institution
yok
Project Number
yok
Thanks
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References
- 1. Ilhan O, Bor M. Platelet mass index and prediction of severity of transient tachypnea of the newborn. Pediatr Int. 2019;61(7):697-705.
- 2. Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am. J. Dis. Child. 1966; 111: 380–5.
- 3. Helve O, Pitkanen O, Janer C, Andersson S. Pulmonary fluid balance in the human newborn infant. Neonatology 2009; 95: 347–52.
- 4. Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr. Respir. Rev. 2013; 14: 29– 36.
- 5. Weyrich AS, Zimmerman GA. Platelets in lung biology. Annu. Rev. Physiol. 2013; 75: 569–91.
- 6. Boutaybi N, Steggerda SJ, Smits-Wintjens VE, van Zwet EW, Walther FJ, Lopriore E. Early-onset thrombocytopenia in near- term and term infants with perinatal asphyxia. Vox. Sang. 2014; 106: 361–7.
- 7. Andrew M, Castle V, Saigal S, Carter C, Kelton JG. Clinical impact of neonatal thrombocytopenia. J. Pediatr. 1987; 110: 457–64.
- 8. Sharma A, Thapar K. A prospective observational study of thrombocytopenia in high risk neonates in a tertiary care teaching hospital. Sri Lanka J. Child Health 2015; 44: 213–9.
- 9. Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul. Fibrinolysis 1996; 7: 157–61.
- 10. Canpolat FE, Yurdak€ok M, Armangil D, Yi!git S. Mean platelet volume in neonatal respiratory distress syndrome. Pediatr. Int. 2009; 51: 314–6.
- 11. Omran A, Ali M, Saleh MH, Zekry O. Salivary C-reactive protein and mean platelet volume in diagnosis of late-onset neonatal pneumonia. Clin. Respir. J. 2018; 12: 1644–50.
- 12. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital. J. Pediatr. 2013; 39: 16.
- 13. Christensen RD. Platelet transfusion in the neonatal intensive care unit: Benefits, risks, alternatives. Neonatology 2011; 100: 311–8.
- 14. Gerday E, Baer VL, Lambert DK et al. Testing platelet mass versus platelet count to guide platelet transfusions in the neonatal intensive care unit. Transfusion 2009; 49: 2034–9.
- 15. Okur N, Buyuktiryaki M, Uras N et al. Platelet mass index in very preterm infants: Can it be used as a parameter for neonatal morbidities? J. Matern. Fetal. Neonatal. Med. 2016; 29: 3218–22.
- 16. Lefrançais E, Ortiz-Munoz G, Caudrillier A et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors. Nature 2017; 544: 105–9.
- 17. Lo SK, Burhop KE, Kaplan JE, Malik AB. Role of platelets in maintenance of pulmonary vascular permeability to protein. Am. J. Physiol. 1988; 254: H763–71.
- 18. Cosar H, Yılmaz O, Bulut Y, Temur M. Red blood cell distribution width and transient tachypnoea of the newborn. HK J. Paediatr. (New Series) 2017; 22: 159–62.
- 19. Martin JF, Bath PMW. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338(8780): 1409–1411.
- 20. Endler G, Klimesch A, Sunder-Plassmann H. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002; 117: 399–404.
- 21. Bath P, Algert C, Chapman N, Neal B, PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004; 35: 622 – 626.
- 22. Wiedmeier SE, Henry E, Sola-Visner MC, Christensen RD. Platelet reference ranges for neonates, defined using data from over 47,000 patients in a multihospital healthcare system. J Perinatol. 2009;29(2):130-136. doi:10.1038/jp.2008.141.
- 23. Bauman ME, Cheung PY, Massicotte MP. Hemostasis and platelet dysfunction in asphyxiated neonates. J. Pediatr. 2011; 158: e35–9.
- 24. Cekmez F, Tanju IA, Canpolat FE et al. Mean platelet volume in very preterm infants: A predictor of morbidities? Eur. Rev. Med. Pharmacol. Sci. 2013; 17: 134–7.
- 25. Hussein NF, Helaly NE, Ghany EA, Anis SK. Relationship between mean platelet volume and bronchopulmonary dysplasia and I_ntraventricular hemorrhage in very low birth weight neonates. J. Am. Sci. 2012;8:324–39.
- 26. Oncel MY, Ozdemir R, Yurttutan S, Canpolat FE, Erdeve O, Oguz SS, Uras N, Dilmen U. Mean platelet volume in neonatal sepsis. J Clin Lab Anal. 2012; 26(6):493-6.
- 27. Patrick CH, Lazarchick J. The effect of bacteremia on automated platelet measurements in neonates. Am J Clin Pathol 1990; 93(3): 391 – 394.
- 28. Beverley DW, Inwood MJ, Chance GW, Schaus M, O’Keefe B. ‘Normal’ haemostasis parameters: a study in a well-defined inborn population of preterm infants. Early Hum Dev 1984; 9(3): 249 – 257.
- 29. Arad ID, Alpan G, Sznajderman SD, Eldor A. The mean platelet volume (MPV) in the neonatal period. Am J Perinatol 1986; 3(1): 1–3.
- 30. Kipper SL, Sieger L. Whole blood platelet volumes in newborn infants. J Pediatr 1982; 101(5): 763 – 766.
- 31. Schmutz N, Henry E, Jopling J, Christensen RD. Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited. J Perinatol. 2008;28(4):275-281. doi:10.1038/sj.jp.7211916.
- 32. Das A, Ray S, Chattopadhyay A, Hazra A, Mondal R. Gestation-wise Reference Ranges of Neutrophil Counts in Indian Newborns. Oman Med J. 2019;34(2):131-136. doi:10.5001/omj.2019.25.
Can Platelet Mass Index Predict Respiratory Support Duration in Late Preterm Infants with Transient Tachypnea of the Newborn?
Abstract
Aim: Transient tachypnea of the newborn (TTN) is the most common respiratory problem encountered by physicians working in the neonatal intensive care unit, and its incidence is higher in late preterm infants compared to term infants. Platelets prevent pulmonary fluid collection and pulmonary edema by an unknown mechanism. Platelet function can be more accurately assessed by platelet mass index (PMI) rather than mean platelet volüme (MPV) or platelet count alone. In our study, it was planned to investigate the duration of need for respiratory support and the relationship between thrombocyte markers, especially PMI, and other respiratory outcomes in late preterm infants with the diagnosis of TTN.
Materials and Methods: In this retrospective study, data of all late preterm newborns whose tachypnea lasted for at least 12 hours and who were hospitalized in the neonatal intensive care unit of Buca Seyfi Demirsoy Training and Research Hospital with the diagnosis of TTN between August 1, 2020-July 31, 2021 were analyzed from medical records. The thrombocyte markers, leukocyte and neutrophil values of the infants and respiratory support durations were compared. In addition, these parameters were evaluated in terms of possible differences according to gestational weeks.
Results: 52 infants were included in the study. The median gestational week was 35 weeks (34-366/7), and the mean birth weight was 2647474. There was no correlation between total respiratory support duration or >48 hours of respiratory support in infants and platelet count, MPV, PMI, leukocyte and absolute neutrophil count (ANS). However, it was observed that the PMI values were lower in babies who received respiratory support for more than 72 hours, and this was statistically significant. In addition, it was observed that MPV value was significantly higher in babies born at 35th gestational week and ANS value was significantly higher in babies born at 36th gestational week.
Conclusion: In our study, it was seen that PMI, one of the platelet markers, was associated with the need for respiratory support for more than 72 hours in late preterm infants with TTN, as the mean PMI values of these infants being lower. However, a similar relationship was not found between other platelet markers and the duration of respiratory support.
Project Number
yok
References
- 1. Ilhan O, Bor M. Platelet mass index and prediction of severity of transient tachypnea of the newborn. Pediatr Int. 2019;61(7):697-705.
- 2. Avery ME, Gatewood OB, Brumley G. Transient tachypnea of newborn. Possible delayed resorption of fluid at birth. Am. J. Dis. Child. 1966; 111: 380–5.
- 3. Helve O, Pitkanen O, Janer C, Andersson S. Pulmonary fluid balance in the human newborn infant. Neonatology 2009; 95: 347–52.
- 4. Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Paediatr. Respir. Rev. 2013; 14: 29– 36.
- 5. Weyrich AS, Zimmerman GA. Platelets in lung biology. Annu. Rev. Physiol. 2013; 75: 569–91.
- 6. Boutaybi N, Steggerda SJ, Smits-Wintjens VE, van Zwet EW, Walther FJ, Lopriore E. Early-onset thrombocytopenia in near- term and term infants with perinatal asphyxia. Vox. Sang. 2014; 106: 361–7.
- 7. Andrew M, Castle V, Saigal S, Carter C, Kelton JG. Clinical impact of neonatal thrombocytopenia. J. Pediatr. 1987; 110: 457–64.
- 8. Sharma A, Thapar K. A prospective observational study of thrombocytopenia in high risk neonates in a tertiary care teaching hospital. Sri Lanka J. Child Health 2015; 44: 213–9.
- 9. Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul. Fibrinolysis 1996; 7: 157–61.
- 10. Canpolat FE, Yurdak€ok M, Armangil D, Yi!git S. Mean platelet volume in neonatal respiratory distress syndrome. Pediatr. Int. 2009; 51: 314–6.
- 11. Omran A, Ali M, Saleh MH, Zekry O. Salivary C-reactive protein and mean platelet volume in diagnosis of late-onset neonatal pneumonia. Clin. Respir. J. 2018; 12: 1644–50.
- 12. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Ital. J. Pediatr. 2013; 39: 16.
- 13. Christensen RD. Platelet transfusion in the neonatal intensive care unit: Benefits, risks, alternatives. Neonatology 2011; 100: 311–8.
- 14. Gerday E, Baer VL, Lambert DK et al. Testing platelet mass versus platelet count to guide platelet transfusions in the neonatal intensive care unit. Transfusion 2009; 49: 2034–9.
- 15. Okur N, Buyuktiryaki M, Uras N et al. Platelet mass index in very preterm infants: Can it be used as a parameter for neonatal morbidities? J. Matern. Fetal. Neonatal. Med. 2016; 29: 3218–22.
- 16. Lefrançais E, Ortiz-Munoz G, Caudrillier A et al. The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors. Nature 2017; 544: 105–9.
- 17. Lo SK, Burhop KE, Kaplan JE, Malik AB. Role of platelets in maintenance of pulmonary vascular permeability to protein. Am. J. Physiol. 1988; 254: H763–71.
- 18. Cosar H, Yılmaz O, Bulut Y, Temur M. Red blood cell distribution width and transient tachypnoea of the newborn. HK J. Paediatr. (New Series) 2017; 22: 159–62.
- 19. Martin JF, Bath PMW. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338(8780): 1409–1411.
- 20. Endler G, Klimesch A, Sunder-Plassmann H. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002; 117: 399–404.
- 21. Bath P, Algert C, Chapman N, Neal B, PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004; 35: 622 – 626.
- 22. Wiedmeier SE, Henry E, Sola-Visner MC, Christensen RD. Platelet reference ranges for neonates, defined using data from over 47,000 patients in a multihospital healthcare system. J Perinatol. 2009;29(2):130-136. doi:10.1038/jp.2008.141.
- 23. Bauman ME, Cheung PY, Massicotte MP. Hemostasis and platelet dysfunction in asphyxiated neonates. J. Pediatr. 2011; 158: e35–9.
- 24. Cekmez F, Tanju IA, Canpolat FE et al. Mean platelet volume in very preterm infants: A predictor of morbidities? Eur. Rev. Med. Pharmacol. Sci. 2013; 17: 134–7.
- 25. Hussein NF, Helaly NE, Ghany EA, Anis SK. Relationship between mean platelet volume and bronchopulmonary dysplasia and I_ntraventricular hemorrhage in very low birth weight neonates. J. Am. Sci. 2012;8:324–39.
- 26. Oncel MY, Ozdemir R, Yurttutan S, Canpolat FE, Erdeve O, Oguz SS, Uras N, Dilmen U. Mean platelet volume in neonatal sepsis. J Clin Lab Anal. 2012; 26(6):493-6.
- 27. Patrick CH, Lazarchick J. The effect of bacteremia on automated platelet measurements in neonates. Am J Clin Pathol 1990; 93(3): 391 – 394.
- 28. Beverley DW, Inwood MJ, Chance GW, Schaus M, O’Keefe B. ‘Normal’ haemostasis parameters: a study in a well-defined inborn population of preterm infants. Early Hum Dev 1984; 9(3): 249 – 257.
- 29. Arad ID, Alpan G, Sznajderman SD, Eldor A. The mean platelet volume (MPV) in the neonatal period. Am J Perinatol 1986; 3(1): 1–3.
- 30. Kipper SL, Sieger L. Whole blood platelet volumes in newborn infants. J Pediatr 1982; 101(5): 763 – 766.
- 31. Schmutz N, Henry E, Jopling J, Christensen RD. Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited. J Perinatol. 2008;28(4):275-281. doi:10.1038/sj.jp.7211916.
- 32. Das A, Ray S, Chattopadhyay A, Hazra A, Mondal R. Gestation-wise Reference Ranges of Neutrophil Counts in Indian Newborns. Oman Med J. 2019;34(2):131-136. doi:10.5001/omj.2019.25.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Research Article |
| Authors | |
| Project Number | yok |
| Publication Date | September 30, 2022 |
| Submission Date | January 24, 2022 |
| Acceptance Date | May 13, 2022 |
| Published in Issue | Year 2022 Volume: 19 Issue: 3 |
