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kpmle2
Forum Guru Topics: 95 Posts: 503 |
what is the treatment for anemia of prematurity?
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ngaybinhyen
| Forum Newbie Topics: 23 Posts: 635
this is a too general Q anemia in prematurity has been an issue in perinatal care Mechanisms - lack of baseline erythropoietin (increased secretion via kidney) and erythropoietic response (relative insensitivity of hepatic oxygen sensor to hypoxia) - blood loss due to sampling - short survival of the RBCs from prematures (40-60ds) - rapid expansion of the RBC mass that accompanies growth - Deficiency of folate, vitamin B12, iron, and vitamin E Rx 1. EPO appears to be safe (current consensus) may reduce the amount of blood transfused over the course of the infants hospital stay - Dose: 25–100 U/kg/dose SC 3 times per week; alternatively, 200–400 U/kg/dose IV/SC 3–5 times per week for 2–6 wk (total dose per wk is 600–1400 U/kg) - Side effects: hypertension, seizure, hypersensitivity reactions, headache, edema, dizziness - Cochrane Meta-analysis + Early use < 8days: limited benefit, increased risk of ROP --> not recommended + Later than 8 days use: reduces the use of >= 1 RBC transfusion (actually most of them got transfused by the time of EPO use) 2. Combined IV/PO iron, folate, vitamin B12 during the first weeks reduces the need for transfusion in extremely low birthweights - Iron: AAP recommends 2-4 mg elemental iron/kg per day; 6 mg if EPO used 3. Vit E (15UI/day) recommended by logical antioxydant activity, associated with higher Hb and lower reticulocyte levels than a control group in some studies. 4. Blood transfusion Based on low hematocrit and clinical manifestations (see attachment) The number of premature getting transfused has dropped markedly recently Attached Files: Transfusion in premi.docx (124 KB, 10 downloads)
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ngaybinhyen
| Forum Newbie Topics: 23 Posts: 635
you have a good Q for this, kpmle2?
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bioguy
| Forum Guru  Topics: 75 Posts: 1038
dude, ngaybinhyen!!! are you a scientist or what??!!! i love your holistic approach to questions.
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nightflight1945
| banned Topics: 32 Posts: 873
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ngaybinhyen
| Forum Newbie Topics: 23 Posts: 635
thanks for your kind words, bioguy I'm learning from these threads 
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