Ebook Manual of neonatal care (7/E): Part 2
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Ebook Manual of neonatal care (7/E): Part 2
https://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2ing the neonatal period and ensuing months. The evaluation of anemia must take into account this developmental process, as well as the infant's physiologic needs.A.Normal development: The physiologic anemia of infancy (1)1In utero, the fetal aortic oxygen saturation is 45%, the erythropoietin levels Ebook Manual of neonatal care (7/E): Part 2 are high, and the RBC production is rapid. The fetal liver is the major site of erythropoietin production.2After birth, the oxygen saturation is 95%.Ebook Manual of neonatal care (7/E): Part 2
and rhe erythropoietin is undetectable. RBC production by day 7 is <1/1 Oth the level in utero. Reticulocyte counts are low, and the hemoglobin levelhttps://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2are (2,3-DPG) (which interacts with hemoglobin A to decrease its affinity for oxygen, thereby enhancing oxygen release to the tissues) are high. As a result, oxygen delivery to the tissues actually increases. This physiologic “anemia” is not a functional anemia in that oxygen delivery to the tissues Ebook Manual of neonatal care (7/E): Part 2 is adequate. Iron from degraded RBCs is stored.4Ar 8 to 12 weeks, hemoglobin levels reach their nadir (seeTtble 45.2), oxygen delivery to the tissuesEbook Manual of neonatal care (7/E): Part 2
is impaired, renal erythropoietin production is stimulated, and RBC production increases.5Infants who have received transfusions in rhe neonatal perihttps://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2rapidly utilized. The reticuloendothelial system has adequate iron for 15 to 20 weeks in term infants. After this time, the hemoglobin level decreases if iron is nor supplied.B.Anemia of prematurity is an exaggeration of the normal physiologic anemia (Tables 45.1 and 45.2).1RBC mass and iron stores Ebook Manual of neonatal care (7/E): Part 2are decreased because of low birth weight; however, hemoglobin concentrations are similar in preterm and term infants.2rhe hemoglobin nadir is reachedEbook Manual of neonatal care (7/E): Part 2
earlier than in the term infant because of rhe following:a.RBC survival is decreased in comparison with the term infant.b.There is a relatively more https://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2increase in total blood volume.564 I ANEMIAHemoglobin Changes in Babies in the First Year of LifeTable 45.1WeekHemoglobin levelTerm babiesPremature babies (1,200-2,500 g)Small premature babies «1,200 g)01716.416118.81614.8315.913.513.4612.710.79.71011.49.88.5201210.49501211.511Source-. Glader B, Nai Ebook Manual of neonatal care (7/E): Part 2man JL. Erythrocyte disorders in infancy. In: Taeusch HW, Ballard RA, Avery ME, eds. Diseases of the Newborn. Philadelphia: WB Saunders; 1991.c.Many pEbook Manual of neonatal care (7/E): Part 2
reterm infants have reduced red cell mass and iron stores because of iatrogenic phlebotomy for laboratory tests. This has been somewhat ameliorated wihttps://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2nadir in premature babies is lower than in term infants, because erythropoietin is produced by the term infant at a hemoglobin level of 10 to 11 g/dL and is produced by the premature infant at a hemoglobin level of 7 to 9 g/dL.4Iron administration before the age of 10 to 14 weeks does not increase t Ebook Manual of neonatal care (7/E): Part 2he nadir of the hemoglobin level or diminish its rate of reduction. However, this iron is stored for later use.5Once the nadir is reached, R.BC producEbook Manual of neonatal care (7/E): Part 2
tion is stimulated, and iron stores are rapidly depleted because less iron is stored in the premature infant chan in the term infant.Hemoglobin Nadir https://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duri Ebook Manual of neonatal care (7/E): Part 2ies (1,200-2,500 g)8.0-10.045056https://khothuvien.cori!45I. HEMATOLOGIC PHYSIOLOGY OF THE NEWBORN (1-5). Significant changes occur in the red blood cell (RBC) mass of an infant duriGọi ngay
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