Anemia of prematurity: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(3 intermediate revisions by one other user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{SI}}
{{ Anemia of prematurity }}
{{CMG}}
{{CMG}}; {{AE}} {{Asra}}
==Overview==
'''Anemia of prematurity''' is a normochromic, normocytic [[anemia]] commonly seen in [[premature birth|premature]] infants cared for in the [[neonatal intensive care unit]]. 
==Pathophysiology==
The total volume of blood in premature infants is approximately 100ml/kg of body weight--approximately 5 ounces for a 1.5kg infant.  Blood sampling done for laboratory testing in the first days of life can easily remove enough blood to produce anemia.  As anemia develops, the amount of oxygen delivered by the hemoglobin in the blood to the body organs declines.  Normally this stimulates increased production of [[erythropoietin]] (EPO), but this response is diminished in premature infants.  While the reason for this decreased response is not fully understood, it is theorized that there is a genetically timed switch from [[liver|hepatic]] production of EPO, which occurs in-utero, to [[kidney|renal]] production.  Since hepatic production is stimulated by lower levels of oxygen delivery (reflecting the lower levels present in the fetus) and since the red blood cells are carrying higher amounts of oxygen after birth, the level of red blood cells itself must drop significantly before EPO production will begin in premature infants who have not yet switched from hepatic to renal EPO production.  This level may be as low as a [[hemoglobin]] of 6.5g/dL, corresponding to an [[hematocrit]] of approximately 19.


==Natural History, Complications and Prognosis==
==[[Anemia of prematurity overview|Overview]]==
Anemia of prematurity may be tolerated in the otherwise healthy premature infant without complications and will eventually spontaneously resolve when EPO production resumes.  However, hemoglobin levels < 10g/dL may be associated with decreased growth, evidence of compensatory increased cardio-respiratory response ([[tachycardia]] and [[hyperventilation|tachypnea]]), and an increase in [[apnea]].


==Treatment==
==[[Anemia of prematurity historical perspective|Historical Perspective]]==
The best treatment is prevention by minimizing the amount of blood drawn from the infant.  Modern technology, including non-invasive pulse-oximetry, development of laboratory equipment that can use very small blood volume samples, and in-dwelling monitors that can measure blood-gas parameters without removing any blood have helped delay or even eliminate anemia of prematurity in some infants.
 
==[[Anemia of prematurity classification|Classification]]==
 
==[[Anemia of prematurity pathophysiology|Pathophysiology]]==
 
==[[Anemia of prematurity causes|Causes]]==
 
==[[Anemia of prematurity differential diagnosis|Differentiating Anemia of prematurity from other Diseases]]==
 
==[[Anemia of prematurity epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Anemia of prematurity risk factors|Risk Factors]]==
 
==[[Anemia of prematurity natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


Recombinant EPO may be given to premature infants to stimulate red blood cell production.  Premature infants are equally responsive to EPO as term infants.  However, the response to EPO typically takes up to 2 weeks.  To date, studies of EPO use in premature infants have had mixed results.  It is likely that only a carefully selected subpopulation of infants may benefit from its use.
==Diagnosis==
[[Anemia of prematurity history and symptoms| History and Symptoms]] | [[Anemia of prematurity physical examination | Physical Examination]] |[[Anemia of prematurity laboratory findings|Laboratory Findings]] | [[Anemia of prematurity ultrasound|Ultrasound]] | [[Anemia of prematurity other imaging findings|Other Imaging Findings]] | [[Anemia of prematurity other diagnostic studies|Other Diagnostic Studies]]


Treatment of symptomatic anemia of prematurity is with blood transfusion.
==Treatment==
[[Anemia of prematurity medical therapy|Medical Therapy]] | [[Anemia of prematurity primary prevention|Primary Prevention]] | [[Anemia of prematurity secondary prevention|Secondary Prevention]] | [[Anemia of prematurity cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Anemia of prematurity future or investigational therapies|Future or Investigational Therapies]]


==References==
==Case Studies==
{{reflist|2}}
[[Anemia of prematurity case study one|Case#1]]


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}

Latest revision as of 16:34, 28 August 2020

Anemia of prematurity Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anemia of prematurity from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Anemia of prematurity On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Anemia of prematurity

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Anemia of prematurity

on Anemia of prematurity

Anemia of prematurity in the news

Blogs on Anemia of prematurity

Directions to Hospitals Treating Anemia of prematurity

Risk calculators and risk factors for Anemia of prematurity

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Asra Firdous, M.B.B.S.[2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anemia of prematurity from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination |Laboratory Findings | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1


Template:WikiDoc Sources