12 ileri kurs1 - Kan Merkezleri ve Transfüzyon Derneği

lar›n kan ›fl›nlama rehberleri bu farkl›l›¤› yans›tmaktad›r.
Ulusal Kan Merkezleri ve Transfüzyon T›bb› Kursu XII - ‹leri Kurs
Ifl›nlama, kan merkezinde kan ›fl›nlama cihaz›nda yap›lmal›d›r. Kan merkezinde ›fl›nlama cihaz› olmayan yerlerde
Radyoterapi cihazlar› da bu ifl için kullan›labilir. Fakat merkez d›fl›nda yap›lmas›ndan dolay› zaman kayb›, randevu ve
doz da¤›l›m›nda dikkatsizlik risklerini tafl›r. Verilecek ›fl›n dozu 25 Gy ve üstüdür (1-5). Kobaltl› cihazlar›n yerini do¤rusal
h›zland›r›c›l› ›fl›n tedavisi cihazlar›n›n almas› sebebiyle bu alternatif yol ortadan kalkmak üzeredir. Ifl›nlama, potasyum
kaç›fl›n› art›rarak hiperpotasemi tehlikesini art›r›r. Bu sebeple ›fl›nlanm›fl kanlar 24 saat içinde kullan›lmam›fl ise
y›kanarak kullan›lmal›d›r. (4,10)
KAYNAKLAR
1. Albayrak D, Uçar-Albayrak C. Yenido¤an ve çocuklarda kan ürünlerinin kullan›m›. Türkiye Klinikleri Dahili Bilimler
Dergisi. 2007; 3:111-120.
2. Uçar C. Pediatride kan ve kan ürünlerinin transfüzyonu. Türkiye Klinikleri Pediatrik Bilimler Dergisi. 2005;
1:115-122.
3. Brugnara C, Platt OS. Neonatal hematology: the neonatal erythrocyte and its disorders. In: Nathan DG, Orkin
STT, Ginsberg D, Look AT (eds) Hematology of Infancy and Childhood, 7th edn. Philadelphia: Saunders, 2009,
pp. 21-66.
4. Gibson BE, Todd A, Roberts I, Pamphilon D, Rodeck C et al. British Committee for standards in Transfusion
Task ForceWriting Group. Transfusion guidelines for neonates and older children. Br J Haematol 2004;
124:433-453.
5. Mark E Brecher (ed) . in (ch 21) Blood transfusion practice. Technical manuel of AABB. 15 th edition. Bethesda.
6. Murray N A, Roberts I A G. Neonatal transfusion practice. Arch Dis Child Fetal Neonatal Ed, 2004;
89:F101–F107.
7. Baer VL, Lambert DK, Schmutz N, Henry E, et al. Adherence to NICU transfusion guidelines: data froma multihospital
healthcare system. J Perinatol, 2008; 28:492-497.
8. New HV. Paediatric transfusion Vox Sanguinis, 2006; 90:1-9.
9. Luban NLC: Neonatal red blood cell transfusions. Vox Sang, 2004; 87 (Suppl. 2):184-188.
10. Hall TL, Barnes A, Miller JR, Bethencourt DM, Nestor L: Neonatal mortality following transfusion of red cells
with high plasma potassium levels. Transfusion, 1993; 33:606-609.
11. Harris B, Lumadue J, Luban NLC, Pollack M.Transfusion-related hyperkalemic arrest from irradiated packed red
blood cells (abstract). Transfusion 1998;38(Suppl):69S.
12. Elbert C, Strauss RG, Barrett F et al. Biological mothers may be dangerous blood donors for their neonates. Acta
Haematol, 1991; 85: 189-191.
13. Aldemir EY, Altuncu E, Kavuncuo¤lu S, Do¤an A, Murat Z. Pretermlerde eritrosit transfüzyonunun s›kl›¤› ve nedenleri.
Türkiye klinikleri pediatri, 2006; 15:139-143.
14. Kuriyan M, Carson JL. Blood transfusion risks in the intensive care unit. Crit Care Clin 2004; 20: 237-253.
15. Bell, EF, Strauss RG, Widness JA, Mahoney LT et al. Randomized Trial of Liberal Versus Restrictive Guidelines
for Red Blood Cell Transfusion in Preterm Infants. Pediatrics, 2005; 115:1685-1691.
16. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. American Academy
of Pediatrics Subcommittee on Hyperbilirubinemia. Pediatrics, 2004; 114:297-316.
17. Dohner ML, Wiedmeier SE, Stoddard RA, Null D Jr, et al. Very high users of platelet transfusions in the neonatal
intensive care unit. Transfusion, 2009; 49:869-872.
18. Strauss RG. Pretransfusion trigger platelet counts and dose for prophylactic platelet transfusions. Curr Opin Hematol,
2005; 12:499-502.
19. Andrew M, Vegh P, Caco C, et al. A randomized, controlled trial of platelet transfusions in trombocytopenic
premature infants. J Pediatr, 1993; 123: 285-291.
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