Advertisement

Hämatologische Probleme

  • Rolf F. Maier

Zusammenfassung

Um Störungen des hämatopoietischen Systems bewerten zu können, müssen die alters- und reifespezifischen Referenzwerte bekannt sein. In diesem Kapitel werden Maßnahmen zur Verhinderung und Behandlung der bei Frühgeborenen regelhaft auftretenden Anämie beschrieben. Auf die Schwierigkeiten bei der Indikationsstellung und die Besonderheiten bei der Durchführung von Transfusionen in der Neonatalperiode wird eingegangen. Zu den durch konsequente Vitamin-K-Substitution leicht zu verhindernden Gerinnungsstörungen zählt der Morbus haemorrhagicus neonatorum. Thrombozytopenien sind in der Neonatalperiode häufig und müssen differenzialdiagnostisch abgeklärt werden.

Literatur

  1. 1.
    Aher SM, Ohlsson A (2014) Late erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants. Cochrane Database Syst Rev:CD004868Google Scholar
  2. 2.
    Amin SC, Remon JI, Subbarao GC, Maheshwari A (2012) Association between red cell transfusions and necrotizing enterocolitis. J Matern Fetal Neonatal Med 25(Suppl 5):85–9Google Scholar
  3. 3.
    Andrew M, Paes B, Milner R, Johnston M, Mitchell L, Tollefsen DM, Castle V, Powers P (1988) Development of the human coagulation system in the healthy premature infant. Blood 72:1651–7Google Scholar
  4. 4.
    Backes CH, Rivera BK, Haque U, Bridge JA, Smith CV, Hutchon DJ, Mercer JS (2014) Placental transfusion strategies in very preterm neonates: a systematic review and meta-analysis. Obstet Gynecol 124:47–56Google Scholar
  5. 5.
    Bakchoul T, Bassler D, Heckmann M, Thiele T, Kiefel V, Gross I, Arnold DM, DiTomasso J, Smith JW, Paes B, Greinacher A (2014) Management of infants born with severe neonatal alloimmune thrombocytopenia: the role of platelet transfusions and intravenous immunoglobulin. Transfusion 54:640–5Google Scholar
  6. 6.
    Bell EF, Strauss RG, Widness JA, Mahoney LT, Mock DM, Seward VJ, Cress GA, Johnson KJ, Kromer IJ, Zimmerman MB (2005) Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants. Pediatrics 115:1685–91Google Scholar
  7. 7.
    Brunskill SJ, Wilkinson KL, Doree C, Trivella M, Stanworth S (2015) Transfusion of fresher versus older red blood cells for all conditions. Cochrane Database Syst Rev:CD010801Google Scholar
  8. 8.
    Chinnadurai S, Fonnesbeck C, Snyder KM, Sathe NA, Morad A, Likis FE, McPheeters ML (2016) Pharmacologic Interventions for Infantile Hemangioma: A Meta-analysis. Pediatrics 137:e20153896Google Scholar
  9. 9.
    Del Vecchio A (2014) Evaluation and management of thrombocytopenic neonates in the intensive care unit. Early Hum Dev 90 Suppl 2:S51–5Google Scholar
  10. 10.
    De Waal KA, Baerts W, Offringa M (2006) Systematic review of the optimal fluid for dilutional exchange transfusion in neonatal polycythaemia. Arch Dis Child Fetal Neonatal Ed 91:F7–10Google Scholar
  11. 11.
    Drolet BA, Frommelt PC, Chamlin SL, Haggstrom A, Bauman NM, Chiu YE, Chun RH, Garzon MC, Holland KE, Liberman L, MacLellan-Tobert S, Mancini AJ, Metry D, Puttgen KB, Seefeldt M, Sidbury R, Ward KM, Blei F, Baselga E, Cassidy L, Darrow DH, Joachim S, Kwon EK, Martin K, Perkins J, Siegel DH, Boucek RJ, Frieden IJ (2013) Initiation and use of propranolol for infantile hemangioma: report of a consensus conference. Pediatrics 131:128–40Google Scholar
  12. 12.
    Forestier F, Daffos F, Catherine N, Renard M, Andreux JP (1991) Developmental hematopoiesis in normal human fetal blood. Blood 77:2360–3Google Scholar
  13. 13.
    Jaffray J, Young G, Ko RH (2016) The bleeding newborn: A review of presentation, diagnosis, and management. Semin Fetal Neonatal Med 21:44–9Google Scholar
  14. 14.
    John CM, Harkensee C (2005) Thrombolytic agents for arterial and venous thromboses in neonates. Cochrane Database Syst Rev:CD004342Google Scholar
  15. 15.
    Kaplan C (2001) Immune thrombocytopenia in the foetus and the newborn: diagnosis and therapy. Transfus Clin Biol 8:311–4Google Scholar
  16. 16.
    Keir AK, Wilkinson D, Andersen C, Stark MJ (2016) Washed versus unwashed red blood cells for transfusion for the prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev:CD011484Google Scholar
  17. 17.
    Kirpalani H, Whyte RK, Andersen C, Asztalos EV, Heddle N, Blajchman MA, Peliowski A, Rios A, LaCorte M, Connelly R, Barrington K, Roberts RS (2006) The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants. J Pediatr 149:301–7Google Scholar
  18. 18.
    Kleihauer E, Hildegard B, Betke K (1957) Demonstration von fetalem Hämoglobin in den Erythrozyten eines Blutausstrichs. Klinische Wochenschrift 35:637–8Google Scholar
  19. 19.
    Maier RF, Obladen M, Muller-Hansen I, Kattner E, Merz U, Arlettaz R, Groneck P, Hammer H, Kossel H, Verellen G, Stock GJ, Lacaze-Masmonteil T, Claris O, Wagner M, Matis J, Gilberg F (2002) Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g. J Pediatr 141:8–15Google Scholar
  20. 20.
    Maier RF, Sonntag J, Walka MM, Liu G, Metze BC, Obladen M (2000) Changing practices of red blood cell transfusions in infants with birth weights less than 1000 g. J Pediatr 136:220–4Google Scholar
  21. 21.
    Maier RF, Obladen M, Scigalla P, Linderkamp O, Duc G, Hieronimi G, Halliday HL, Versmold HT, Moriette G, Jorch G et al. (1994) The effect of epoetin beta (recombinant human erythropoietin) on the need for transfusion in very-low-birth-weight infants. European Multicentre Erythropoietin Study Group. N Engl J Med 330:1173–8Google Scholar
  22. 22.
    March MI, Hacker MR, Parson AW, Modest AM, de Veciana M (2013) The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial. J Perinatol 33:763–7Google Scholar
  23. 23.
    Mills RJ, Davies MW (2012) Enteral iron supplementation in preterm and low birth weight infants. Cochrane Database Syst Rev:CD005095Google Scholar
  24. 24.
    Mouzinho A, Rosenfeld CR, Sanchez PJ, Risser R (1994) Revised reference ranges for circulating neutrophils in very-low-birth-weight neonates. Pediatrics 94:76–82Google Scholar
  25. 25.
    Nathan DG, Orkin SH, Look AT (2003) Nathan and Oski´s Hematology of infancy and childhood. 6th Ed. WB Saunders, PhiladelphiaGoogle Scholar
  26. 26.
    Nowak-Göttl U, Auberger K, Halimeh S, Junker R, Klinge J, Kreuz WD, Ries M, Schlegel N (1999) Thrombolysis in newborns and infants. Thromb Haemost 82 Suppl 1:112–6Google Scholar
  27. 27.
    Obladen M, Diepold K, Maier RF (2000) Venous and arterial hematologic profiles of very low birth weight infants. European Multicenter rhEPO Study Group. Pediatrics 106:707–11Google Scholar
  28. 28.
    Obladen M, Sachsenweger M, Stahnke M (1988) Blood sampling in very low birth weight infants receiving different levels of intensive care. Eur J Pediatr 147:399–404Google Scholar
  29. 29.
    Ohls RK, Christensen RD, Kamath-Rayne BD, Rosenberg A, Wiedmeier SE, Roohi M, Lacy CB, Lambert DK, Burnett JJ, Pruckler B, Schrader R, Lowe JR (2013) A randomized, masked, placebo-controlled study of darbepoetin alfa in preterm infants. Pediatrics 132:e119–27Google Scholar
  30. 30.
    Ohlsson A, Aher SM (2014) Early erythropoietin for preventing red blood cell transfusion in preterm and/or low birth weight infants. Cochrane Database Syst Rev:CD004863Google Scholar
  31. 31.
    Ovadia SA, Landy DC, Cohen ER, Yang EY, Thaller SR (2015) Local administration of β-blockers for infantile hemangiomas: a systematic review and meta-analysis. Ann Plast Surg 74:256–62Google Scholar
  32. 32.
    Özek E, Soll R, Schimmel MS (2010) Partial exchange transfusion to prevent neurodevelopmental disability in infants with polycythemia. Cochrane Database Syst Rev:CD005089Google Scholar
  33. 33.
    Patel RM, Knezevic A, Shenvi N, Hinkes M, Keene S, Roback JD, Easley KA, Josephson CD (2016) Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants. JAMA 315:889–97Google Scholar
  34. 34.
    Paul DA, Mackley A, Novitsky A, Zhao Y, Brooks A, Locke RG (2011) Increased odds of necrotizing enterocolitis after transfusion of red blood cells in premature infants. Pediatrics 127:635–41Google Scholar
  35. 35.
    Pereira SP, Shearer MJ, Williams R, Mieli-Vergani G (2003) Intestinal absorption of mixed micellar phylloquinone (vitamin K1) is unreliable in infants with conjugated hyperbilirubinaemia: implications for oral prophylaxis of vitamin K deficiency bleeding. Arch Dis Child Fetal Neonatal Ed 88:F113–8Google Scholar
  36. 36.
    Puckett RM, Offringa M (2000) Prophylactic vitamin K for vitamin K deficiency bleeding in neonates. Cochrane Database Syst Rev:CD002776Google Scholar
  37. 37.
    Rabe H, Diaz-Rossello JL, Duley L, Dowswell T (2012) Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database Syst Rev:CD003248Google Scholar
  38. 38.
    Rabe H, Jewison A, Alvarez RF, Crook D, Stilton D, Bradley R, Holden D; Brighton Perinatal Study Group (2011) Milking compared with delayed cord clamping to increase placental transfusion in preterm neonates: a randomized controlled trial. Obstet Gynecol 117:205–11Google Scholar
  39. 39.
    Rayment R, Brunskill SJ, Soothill PW, Roberts DJ, Bussel JB, Murphy MF (2011). Antenatal interventions for fetomaternal alloimmune thrombocytopenia. Cochrane Database Syst Rev:CD004226Google Scholar
  40. 40.
    Roberts I, Stanworth S, Murray NA (2008) Thrombocytopenia in the neonate. Blood Rev 22:173–86Google Scholar
  41. 41.
    Schelonka RL, Yoder BA, desJardins SE, Hall RB, Butler J (1994) Peripheral leukocyte count and leukocyte indexes in healthy newborn term infants. J Pediatr 125:603–6Google Scholar
  42. 42.
    te Pas AB, Lopriore E, van den Akker ES, Oepkes D, Kanhai HH, Brand A, Walther FJ (2007) Postnatal management of fetal and neonatal alloimmune thrombocytopenia: the role of matched platelet transfusion and IVIG. Eur J Pediatr 166:1057–63Google Scholar
  43. 43.
    Van Winckel M, De Bruyne R, Van De Velde S, Van Biervliet S (2009) Vitamin K, an update for the paediatrician. Eur J Pediatr 168:127–34Google Scholar
  44. 44.
    Walka MM, Sonntag J, Kage A, Dudenhausen JW, Obladen M (1998) Complete blood counts from umbilical cords of healthy term newborns by two automated cytometers. Acta Haematol 100:167–73Google Scholar
  45. 45.
    Whyte R, Kirpalani H (2011) Low versus high haemoglobin concentration threshold for blood transfusion for preventing morbidity and mortality in very low birth weight infants. Cochrane Database Syst Rev:CD000512Google Scholar
  46. 46.
    Whyte RK, Kirpalani H, Asztalos EV, Andersen C, Blajchman M, Heddle N, LaCorte M, Robertson CM, Clarke MC, Vincer MJ, Doyle LW, Roberts RS (2009) Neurodevelopmental outcome of extremely low birth weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion. Pediatrics 123:207–13Google Scholar
  47. 47.
    Xanthou M, Bracci R, Prindull G (eds) (1993) Neonatal haematology and immunology II. Elsevier, AmsterdamGoogle Scholar

Copyright information

© Springer-Verlag GmbH Deutschland 2017

Authors and Affiliations

  • Rolf F. Maier
    • 1
  1. 1.Zentrum für Kinder- und JugendmedizinUniversitätsklinikum MarburgMarburg

Personalised recommendations