GOMELLA NEONATOLOGY PDF
TRICIA LACY GOMELLA, MD Clinical Professor of Pediatrics/Neonatology Chief and Louise Lenoir Locke Professor of Neonatology. Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs - fifth edition. Editor. Tricia Lacy Gomella, MD. Part-Time. Neonatology By Gomella 7th Edition Ebook Download, Free Neonatology By Gomella. 7th Edition Download Pdf, Free Pdf Neonatology By Gomella 7th Edition.
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This document does not consider the indications for the use of blood derivatives and some highly specialised, life-saving techniques used in particular emergencies, such as extracorporeal membrane oxygenation and cardiopulmonary bypass.
General criteria Blood donors and blood components The choice of donor may contribute to reduce the risk of transmission of infectious diseases; it is, therefore, recommended that only blood components obtained from repeat blood donors are used, as set out in current legislation in Italy 1 — 4.
Neonatology 7th Edition (7th ed.)
Leucodepletion The use of leucodepleted blood components has the now undisputed advantages of: - preventing non-haemolytic febrile reactions; - reducing the risk of alloimmunisation; - lowering the risk of transmission of cytomegalovirus CMV infection. However, neither donation from CMV-negative donors nor leucodepletion, nor indeed the combination of strategies, is able to completely eliminate the risk of transmission of CMV infection, because of the possible, occasional cases of viraemia in the initial stage of the infection 7.
The blood components must be irradiated with a dose ranging between 25 and 50 Gray 2,—5, rad.
Units destined for transfusion to neonates must be chosen from those collected within the preceding 5 days. Once irradiated, the RBC must be transfused within 24 hours; if that is not possible, they must be washed with physiological saline in order to remove any excess of potassium and, possibly, in a closed circuit to limit the risk of bacterial contamination. Once washed, the RBC must be transfused as soon as possible and, in any case, not later than 24 hours after preparation.
It is good transfusion practice to irradiate the blood component immediately prior to transfusion 1. Irradiation does not change the expiry data of platelet concentrates 1. In the case of transfusion of small volumes, it is good practice to irradiate only the fraction destined for transfusion, rather than the whole unit Level of evidence IV, Grade of recommendation C.
The remaining sub-units should be irradiated within a maximum of 14 days of collection of the parent unit 1. In order to guarantee optimal transfusion support, the turnover of irradiated units should be rapid, reserving the freshest units irradiated the least time previously preferably on the same day as transfusion for neonates.
In the exceptional case of administration of granulocyte concentrates, these must always be irradiated and transfused as soon as possible, but in any case within 24 hours 1 Level of evidence III, Grade of recommendation B. Pre-transfusion tests The initial tests should include the following.
However, it is good practice to search for and identify antibody specificities in maternal blood; thus, the use of these tests in the neonate should be limited to cases in which a sample of maternal blood is not available.
If the maternal serum contains a clinically relevant antibody, the neonate must be transfused with red blood cells lacking the antigen to which the antibody is directed. Precautions and considerations In the neonatal period, as in every other period of life, all measures must be taken to avoid errors in identification of the units of blood components and of the recipient, exchanges of samples, and labelling errors.
Intrauterine foetal transfusion In the last decade there has been a gradual decline in the use of this technique.
PDF Neonatology 7th Edition (Neonatology (Gomella)) Read Online
Plasmapheresis associated with the infusion of intravenous immunoglobulins IVIG seems to offer an effective, alternative antenatal treatment in cases of severe HDFN 14 , However, intrauterine foetal transfusion appears to be the most effective transfusion practice for a quick recovery from severe foetal anaemia Intrauterine foetal transfusion with packed red cells is mainly indicated for correcting foetal anaemia secondary to the haemolytic action of alloantibodies against blood group antigens present on foetal erythrocytes the antigens most frequently involved are: D, c, E, K, Fya, Jka.
Gomella's Neonatology, Eighth Edition
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Neonatology 7th Edition 7th ed. This document deals with pre-transfusion tests, indications for the transfusion of blood components, characteristics of the blood components and methods of their administration for neonates. In the case of transfusion of small volumes, it is good practice to irradiate only the fraction destined for transfusion, rather than the whole unit Level of evidence IV, Grade of recommendation C. Embed Size px.
It is, however, essential to establish appropriate transfusion criteria for these subjects. Considering that an approximately one percentage point decrease in the haematocrit Hct can be expected daily, the procedure should be repeated at intervals of about 2—3 weeks until the time of the planned delivery.
Furthermore, it should be appreciated that neonatal transfusion medicine is, like all other scientific fields, a continuously evolving discipline.
It is good transfusion practice to irradiate the blood component immediately prior to transfusion 1.
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