Transfusion kuapo

ʻO ka transfusion Exchange kahi hana mālama ola i hana ʻia e pale aku ai i nā hopena o ka jaundice koʻikoʻi a i ʻole nā ​​loli i ke koko ma muli o nā maʻi e like me ka anemia maʻi maʻi.

Hoʻopili ke kaʻina hana me ka lohi i ka lawe ʻana i ke koko o ke kanaka a hoʻololi iā ia me ke koko hāʻawi hou a i ʻole ka plasma.

Pono kahi transfusion exchange e wehe i ke koko o ke kanaka a hoʻololi ʻia. I ka hapanui o nā hihia, pili kēia i ke kau ʻana i hoʻokahi a ʻoi aku o nā paipu lahilahi, i kapa ʻia nā catheters, i loko o kahi kīʻaha koko. Hana ʻia ka transfusion exchange i nā pōʻaiapuni, ʻo kēlā me kēia mea pinepine mau i kekahi mau minuke.

Hoʻihoʻi mālie ʻia ke koko o ke kanaka (ʻo ka manawa pinepine ma kahi o 5 a 20 mL i ka manawa, ke kaukaʻi ʻia i ka nui o ke kanaka a me ke koʻikoʻi o nā maʻi). ʻO ka nui o ke koko hou, prewarmed a i ʻole ka wai kahe e kahe ana i loko o ke kino o ke kanaka. Hoʻomaʻa hou ʻia kēia pōʻaiapuni a hiki i ka hoʻololi ʻia ʻana o ka leo kūpono o ke koko.

Ma hope o ka transfusion exchange, e waiho ʻia paha nā catheters ma kahi e pono ai e hana hou i ke kaʻina hana.

I nā maʻi e like me ka anemia o ka maʻi maʻi, lawe ʻia ke koko a hoʻololi ʻia me ke koko hāʻawi.

I nā kūlana e like me neonatal polycythemia, lawe ʻia kahi kiko kikoʻī o ke koko o ke keiki a hoʻololi ʻia me kahi hopena saline maʻamau, ka plasma (ka ʻāpana wai piha o ke koko), a i ʻole albumin (kahi hopena o nā protein protein). Hoʻoemi kēia i ka helu o nā hunaola ʻulaʻula i loko o ke kino a maʻalahi hoʻi i ke kahe o ke koko i loko o ke kino.

Pono paha kahi transfusion hoʻololi e mālama i nā ʻano aʻe:

• Heluhelu nui ʻia ke koko ʻulaʻula koʻikoʻi i kahi keiki hānau (polycythemia neonatal)
• ʻO ka maʻi hemolytic Rh-i hoʻokomo ʻia o ka hānau hou
• Nā haunaele koʻikoʻi i ke kemika o ke kino
• ʻO ka jaundice hānau hou ʻole e pane i ka phototherapy me nā kukui bili
• Pilikia maʻi ʻaʻai loa
• Nā hopena ʻona o kekahi mau lāʻau

ʻO nā pilikia āpau e like me nā transfusion. ʻO nā pilikia kūpono ʻē aʻe e pili pū me:

• Huʻi koko
• Nā loli i ke kemika o ke koko (kiʻekiʻe a hoʻohaʻahaʻa potassium paha, haʻahaʻa calcium, haʻahaʻa glucose, hoʻololi i ka koena acid-base i loko o ke koko)
• Nā pilikia puʻuwai a me ka māmā
• Maʻiʻaʻai (loa haʻahaʻa kamepiula ma muli o ka akahele kānana o ke koko)
• Pākuʻi inā ʻaʻole lawa ke kuapo o ke koko

Pono e kiaʻi ʻia ka mea maʻi no kekahi mau lā i ka haukapila ma hope o ka hoʻolilo ʻia ʻana. ʻO ka lōʻihi o ka noho ʻana e pili ana i ke ʻano o ka transfusion exchange i hana ʻia ai e mālama.

Maʻi Hemolytic - transfusion exchange

• Jaundice hānau hou - hoʻokuʻu

• Exchange transfusion - moʻo

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ʻO Josephson CD, Sloan SR. Lāʻau lapaʻau transfusion Pediatric. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 121.

ʻO Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Nā maʻi koko. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 124.

Watchko JF. ʻO ka hyperbilirubinemia ʻole neonatal a me ka kernicterus. I: Gleason CA, Juul SE, eds. Nā maʻi o Avery o ke keiki hānau. 10 o ka lā. Piladelapia, PA: Elsevier; 2018: chap 84.