.: ORİJİNAL ARAŞTIRMA
Düşük Doğum Ağırlıklı Bebeklerde Anestezi Deneyimlerimiz: Retrospektif Çalışma
Our Experiences with Anesthesia in Low Birth Weight Infants: Retrospective Study
Turkiye Klinikleri J Anest Reanim. 2022;20(3):97-104
doi: 10.5336/anesthe.2022-89463
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Düşük doğum ağırlığı; 2.500 g ve altı olan, yüksek morbidite ve mortalite riski taşıyan bebekleri tanımlamak için kullanılır. Bu çalışmada, bu bebeklerin anestezi ve cerrahi açıdan özellikleri ve 3 aylık sağkalımlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Hastaların dosyalarından gestasyonel yaş ve doğum ağırlıkları, operasyon sırasındaki yaş, kilo, preoperatif özellikleri, Amerikan Anestezi Derneği [American Society of Anesthesiologists (ASA)] skor durumu, yapılan cerrahi müdahaleler, operasyon süresi, anestezi sırasında oluşan komplikasyonlar, inotropik ilaç ve kafein alan, kan transfüzyonu yapılan hastalar ve 3 aylık mortaliteleri incelendi. Bulgular: Çalışmaya 118 hasta ve 143 operasyon dâhil edildi. Operasyon öncesi hastaların 12'sinin ASA II, 86'sının ASA III, 45'inin ASA IV olarak değerlendirildiği görüldü. Hastaların %88,1'inin doğum haftası <37 idi. Operasyon sırasında hastaların %58,7'si 2.500-1.501 g, %30,8'i 1.500-1.001 g, %10,5'i ise <1.000 g ağırlıktaydı. Operasyona alınan hastaların yaş ortalaması 17,3 (1-123) gün idi. En sık görülen komorbid hastalık; respiratuvar distres sendromu (%28,0), sepsis (%22,4) ve patent duktus arteriosus (%21,0) idi. En sık yapılan 3 cerrahi operasyon; şant (n=19), meningomiyelosel (n=13) ve nekrotizan enterokolit (n=12) idi. Üç aylık survey %70,3, mortalite oranı %29,7 idi. Bu ölümlerin %23,6'sı ilk 1 aylık dönemde meydana geldi. Hastaların 4'ü (%3,3) ilk 24 saatte eksitus oldu. Sonuç: Genel anestezi ile cerrahi operasyona alınan 2.500 g ve altı bebeklerde 3 aylık mortalite insidansı (%29,7) yüksekti.
Anahtar Kelimeler: Anestezi; düşük doğum ağırlığı; prematüre; sonuçlar
Amaç: Düşük doğum ağırlığı; 2.500 g ve altı olan, yüksek morbidite ve mortalite riski taşıyan bebekleri tanımlamak için kullanılır. Bu çalışmada, bu bebeklerin anestezi ve cerrahi açıdan özellikleri ve 3 aylık sağkalımlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Hastaların dosyalarından gestasyonel yaş ve doğum ağırlıkları, operasyon sırasındaki yaş, kilo, preoperatif özellikleri, Amerikan Anestezi Derneği [American Society of Anesthesiologists (ASA)] skor durumu, yapılan cerrahi müdahaleler, operasyon süresi, anestezi sırasında oluşan komplikasyonlar, inotropik ilaç ve kafein alan, kan transfüzyonu yapılan hastalar ve 3 aylık mortaliteleri incelendi. Bulgular: Çalışmaya 118 hasta ve 143 operasyon dâhil edildi. Operasyon öncesi hastaların 12'sinin ASA II, 86'sının ASA III, 45'inin ASA IV olarak değerlendirildiği görüldü. Hastaların %88,1'inin doğum haftası <37 idi. Operasyon sırasında hastaların %58,7'si 2.500-1.501 g, %30,8'i 1.500-1.001 g, %10,5'i ise <1.000 g ağırlıktaydı. Operasyona alınan hastaların yaş ortalaması 17,3 (1-123) gün idi. En sık görülen komorbid hastalık; respiratuvar distres sendromu (%28,0), sepsis (%22,4) ve patent duktus arteriosus (%21,0) idi. En sık yapılan 3 cerrahi operasyon; şant (n=19), meningomiyelosel (n=13) ve nekrotizan enterokolit (n=12) idi. Üç aylık survey %70,3, mortalite oranı %29,7 idi. Bu ölümlerin %23,6'sı ilk 1 aylık dönemde meydana geldi. Hastaların 4'ü (%3,3) ilk 24 saatte eksitus oldu. Sonuç: Genel anestezi ile cerrahi operasyona alınan 2.500 g ve altı bebeklerde 3 aylık mortalite insidansı (%29,7) yüksekti.
Anahtar Kelimeler: Anestezi; düşük doğum ağırlığı; prematüre; sonuçlar
ABSTRACT
Objective: Low birth weight is used to define infants whose body weight is below 2,500 g and who has hıgh morbidity and mortality risk. We aimed to evaluate the anesthesia and surgical characteristics and 3 month survival of these babies. Material and Methods: Gestational age and birth weight, age at the time of the operation, weight, preoperative characteristics, American Society of Anesthesiologists (ASA) score, surgical interventions, duration of the operation, complications during anesthesia, patients receiving inotropic drug and caffeine, blood transfusions, and 3 month mortality were analyzed from the files of the patients. Results: The study included 118 patients and 143 operations. It was seen that 12 of the patients were evaluated as ASA II, 86 as ASA III, 45 as ASA IV before the operation. The gestational week of 88.1% of the patients was <37. During the operation, 58.7% of the patients weighted 2,500-1,501 g, 30.8% 1,500- 1,001 g, and 10.5% <1,000 g. The mean age of the patients was 17.3 (1- 123) days. The most common comorbid diseases were respiratory distress syndrome (28.0%), sepsis (22.4%) and patent ductus arteriosus (21.0%). The 3 most frequently performed surgical operations were; shunt (n=19), meningomyelocele (n=13), and necrotizing enterocolitis (n=12). The 3-month survivale was 70.3%, the mortality rate was 29.7%. 23.6% of these deaths occurred in the first month. Four (3.3%) of the patients died in the first 24 hours. Conclusion: The incidence of 3-month mortality was high (29.7%) in babies weighing 2,500 g and below who underwent surgery under general anesthesia.
Keywords: Anesthesia; low birth weight; premature; outcomes
Objective: Low birth weight is used to define infants whose body weight is below 2,500 g and who has hıgh morbidity and mortality risk. We aimed to evaluate the anesthesia and surgical characteristics and 3 month survival of these babies. Material and Methods: Gestational age and birth weight, age at the time of the operation, weight, preoperative characteristics, American Society of Anesthesiologists (ASA) score, surgical interventions, duration of the operation, complications during anesthesia, patients receiving inotropic drug and caffeine, blood transfusions, and 3 month mortality were analyzed from the files of the patients. Results: The study included 118 patients and 143 operations. It was seen that 12 of the patients were evaluated as ASA II, 86 as ASA III, 45 as ASA IV before the operation. The gestational week of 88.1% of the patients was <37. During the operation, 58.7% of the patients weighted 2,500-1,501 g, 30.8% 1,500- 1,001 g, and 10.5% <1,000 g. The mean age of the patients was 17.3 (1- 123) days. The most common comorbid diseases were respiratory distress syndrome (28.0%), sepsis (22.4%) and patent ductus arteriosus (21.0%). The 3 most frequently performed surgical operations were; shunt (n=19), meningomyelocele (n=13), and necrotizing enterocolitis (n=12). The 3-month survivale was 70.3%, the mortality rate was 29.7%. 23.6% of these deaths occurred in the first month. Four (3.3%) of the patients died in the first 24 hours. Conclusion: The incidence of 3-month mortality was high (29.7%) in babies weighing 2,500 g and below who underwent surgery under general anesthesia.
Keywords: Anesthesia; low birth weight; premature; outcomes
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