Hemorragia intraventricular en prematuros y su relación con la transfusión de glóbulos rojos, de la Unidad de Cuidados Intensivos Neonatales del Hospital Roberto Gilbert, periodo enero 2018 a diciembre 2023.

Abstract

Introduction: Intraventricular hemorrhage (IVH) in premature infants occurs in 95% of cases within 72 hours and in 99% within 7 days of life. Red blood cell transfusion can cause vascular rupture of the immature germinal matrix due to increased pressure and/or microvascular obstruction. Methods: Observational, retrospective, longitudinal and analytical cohort study. Results: 249 premature infants with IVH, aged older than 28 and younger than 37 weeks of gestation (GS), diagnosed with IVH by transfontanelar ultrasound during the first week of life and followed for progression until 10 days of life, were included. The groups were divided into two groups: those who received (n=99) or those who did not (n=150) received red blood cell transfusions. No direct causal relationship between transfusion and the development of IVH was found, but a statistically significant relationship was found in the bivariate analysis for the progression from mild to severe (OR: 5.4494; 95% CI: 1.1622-25.5526; p = 0.04). In the multivariate logistic regression, aggravating factors for progression were found such as: anemia (OR: 9.223; 95% CI: 2.343-51.985; p = 0.002), surfactant (OR: 12.563; 95% CI: 6.069-525.407; p = <0.001) and acidemia (OR: 7.664; 95% CI: 2.095-75.599; p = 0.006). While for mortality: transfusion (OR: 14.676; 95% CI: 2.866-26.033; p = <0.001), progression OR: 7.029; 95% CI: 1.586-21.638; p = 0.008), anemia (OR: 25.889; 95% CI: 5.024-37.974; p = <0.001), surfactant (OR: 12.923; 95% CI: 2.741-30.753; p = <0.001), dopamine (OR: 24.121; 95% CI: 6.434-76.254; p = <0.001) and acidemia (OR: 9.539; 95% CI: 3.636-322.293; p = 0.002). Conclusions: Red blood cell transfusion has no direct causal relationship with the development of IVH, but it is an aggravating factor in the progression to severe IVH and mortality in premature infants.