Determinación de los niveles de hematócrito y hemoglobina y su relación en pacientes neonatos con ictericia estudio realizado en la Maternidad Enrique C. Sotomayor; en el año 2009
Fecha
2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Tecnología Médica
Resumen
La ictericia en el neonato es un signo clínico caracterizado por la pigmentación amarilla en piel, mucosa y fluidos corporales, la mayor parte de las veces es un hecho fisiológico, causado por una hiperbilirrubinemia de predominio indirecto secundario a inmadurez hepática e hiperproducción de la bilirrubina. Constituye uno de los fenómenos clínicos más frecuentes durante el período neonatal y la causa más común de reinternación en salas de cuidados de RN de la Maternidad Enrique C. Sotomayor durante las dos primeras semanas de vida. El problema ha sido motivo de preocupación dado que la ictericia patológica grave produce daño del sistema nervioso central. Sin embargo, existen varias pruebas para determinar la ictericia en los neonatos, pero nuestro objetivo principal fue demostrar en una población de neonatos con ictericia la relación directa con los niveles de hematocrito y hemoglobina de la cual tomamos una muestra de sangre capilar en doscientos pacientes neonatos con ictericia, el cual fue un estudio prospectivo descriptivo y de corte transversal en que a todas las muestras se les realizó las pruebas del hematocrito y la hemoglobina. Obteniendo un gran número de muestras con niveles bajos los cuales se los asoció con la presencia de una enfermedad de causa hemolítica produciendo grandes cantidades de bilirrubina, superando la capacidad hepática de captación y conjugación, dando lugar a una hiperbilirrubinemia no conjugada produciéndose una neurotoxicidad de la bilirrubina y por ende una Kernicterus o dejar secuelas. Además se observó que de éstos neonatos ictéricos con niveles bajos de hematocrito y hemoglobina había prematuros que fueron más propensos de presentar neurotoxicidad de la bilirrubina ya que tienen un hígado inmaduro incapaz de procesar la bilirrubina. Lo cual fue importante para dar un correcto diagnóstico al neonato.
Jaundice in the neonate is a clinical sign characterized by yellow pigmentation in skin, mucosa and body fluids, most of the time it is a physiological event, caused by hyperbilirubinemia of indirect prevalence secondary to liver immaturity and hyperproduction of bilirubin. It constitutes one of the most frequent clinical phenomena during the neonatal period and the most common cause of reinternation in RN care rooms in the Enrique C. Sotomayor Maternity ward during the first two weeks of life. The problem has been a cause for concern since severe pathological jaundice causes damage to the central nervous system. However, there are several tests to determine jaundice in neonates, but our main objective was to demonstrate in a population of neonates with jaundice the direct relationship with hematocrit and hemoglobin levels from which we took a sample of capillary blood in two hundred neonatal patients with jaundice, which was a prospective descriptive and cross-sectional study in which all samples were tested for hematocrit and hemoglobin. Obtaining a large number of samples with low levels which were associated with the presence of a disease of hemolytic cause producing large amounts of bilirubin, exceeding the hepatic capacity of uptake and conjugation, resulting in unconjugated hyperbilirubinemia producing a neurotoxicity of the bilirubin and therefore a Kernicterus or leave sequels. In addition, it was observed that of these icteric infants with low levels of hematocrit and hemoglobin there were premature infants who were more likely to have neurotoxicity of bilirubin since they have an immature liver unable to process bilirubin. Which was important to give a correct diagnosis to the newborn
Jaundice in the neonate is a clinical sign characterized by yellow pigmentation in skin, mucosa and body fluids, most of the time it is a physiological event, caused by hyperbilirubinemia of indirect prevalence secondary to liver immaturity and hyperproduction of bilirubin. It constitutes one of the most frequent clinical phenomena during the neonatal period and the most common cause of reinternation in RN care rooms in the Enrique C. Sotomayor Maternity ward during the first two weeks of life. The problem has been a cause for concern since severe pathological jaundice causes damage to the central nervous system. However, there are several tests to determine jaundice in neonates, but our main objective was to demonstrate in a population of neonates with jaundice the direct relationship with hematocrit and hemoglobin levels from which we took a sample of capillary blood in two hundred neonatal patients with jaundice, which was a prospective descriptive and cross-sectional study in which all samples were tested for hematocrit and hemoglobin. Obtaining a large number of samples with low levels which were associated with the presence of a disease of hemolytic cause producing large amounts of bilirubin, exceeding the hepatic capacity of uptake and conjugation, resulting in unconjugated hyperbilirubinemia producing a neurotoxicity of the bilirubin and therefore a Kernicterus or leave sequels. In addition, it was observed that of these icteric infants with low levels of hematocrit and hemoglobin there were premature infants who were more likely to have neurotoxicity of bilirubin since they have an immature liver unable to process bilirubin. Which was important to give a correct diagnosis to the newborn
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Ictericia, Recién nacido, Hoperbilirrubinemia, Hematócrito, Hospital Gineco-Obstétrico Enrique C. Sotomayor, Cantón Guayaquil, Ecuador, Hemoglobinas