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Determination of tissue hypoxia by physicochemical approach in premature anemia

机译：物理化学方法测定早产贫血中的组织缺氧

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Background: Anemia is a common problem in premature infants and its most rapid and effective therapy is erythrocyte transfusion. However, owing to inherent risks of transfusion in this population, transfusions should be administered only when adequate oxygen delivery to tissues is impaired. The aim of this study was to determine tissue acid levels using Stewart method in an attempt to evaluate the tissue oxygenation level and thereby the accuracy of transfusion timing. Methods: This study included 47 infants delivered at gestational age below 34 weeks who required erythrocyte transfusion for premature anemia. Strong ion gap (SIG), unmeasurable anions (UMA), tissue acid levels (TA), and Cl/Na ratios were calculated before and after transfusion. Results: The mean birth weight and gestational age of the study population were 1210 +/- 365 g and 29.2 +/- 2.7 weeks, respectively. Tissue acid levels were increased (TA >= 4) and tissue hypoxia developed in 10 (16.6%) of 60 erythrocyte transfusions administered according to the restrictive transfusion approach. The patients were divided into two groups according to tissue acid levels as low ( =4) tissue acid groups. The group with tissue hypoxia (TA >= 4) had significantly higher UMA levels but a significantly lower Cl/Na ratio; and UMA levels decreased and Cl/Na ratio increased after transfusion in this group. Tissue hypoxia secondary to anemia was shown to be improved by erythrocyte transfusion. Conclusion: The results of the present study suggest that the determination of the level of tissue hypoxia by the Stewart approach may be an alternative to restrictive transfusion guidelines for timing of transfusion in premature anemia. It also showed that a low Cl/Na ratio can be used as a simple marker of tissue hypoxia.
机译：背景：贫血是早产儿常见的问题，其最快速，最有效的治疗方法是输血。但是，由于该人群存在固有的输血风险，因此，仅当向组织的氧气输送不足时才应进行输血。这项研究的目的是使用Stewart方法确定组织的酸水平，以评估组织的氧合水平，从而评估输血时间的准确性。方法：该研究纳入了47名在孕龄低于34周分娩的婴儿，这些婴儿需要输血治疗早产性贫血。在输血前后计算强离子间隙（SIG），不可测阴离子（UMA），组织酸水平（TA）和Cl / Na比。结果：研究人群的平均出生体重和胎龄分别为1210 +/- 365 g和29.2 +/- 2.7周。根据限制性输注方法进行的60例红细胞输注中，有10例（16.6％）的组织酸水平升高（TA> = 4），组织缺氧。根据组织酸水平将患者分为两组（低（= 4）组织酸组）。组织缺氧（TA> = 4）组的UMA水平显着升高，但Cl / Na比显着降低。该组输血后UMA水平降低，Cl / Na比升高。贫血继发的组织缺氧通过红细胞输注得到改善。结论：本研究的结果表明，通过Stewart方法确定组织缺氧水平可能是限制性输血指南的替代方法，以指导早产贫血的输血时间。它还表明低的Cl / Na比可以用作组织缺氧的简单标志。

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