Prematürelerde İntraventriküler Kanama: Risk Faktörleri, Koruyucu Önlemler Ve Nöroprotektif Hemşirelik Bakımı

Yıl 2024, Cilt: 6 Sayı: 2, 417 - 426, 22.08.2024

Fatma Çarıkçı , Burcu Aykanat Girgin , Yağmur Kul

https://doi.org/10.46413/boneyusbad.1437959

Öz

İntraventriküler kanama, yenidoğanlarda nörolojik gelişimi bozabilen ciddi bir komplikasyondur. Prematürelerde doğum sonrası sıklıkla ilk 72 saat içinde görülmekte ve beyin dokusuna zarar vererek hidrosefali, serebral palsi, mental retardasyon gibi ciddi nörolojik sonuçlara yol açabilmektedir. Prematüreler intrauterin gelişimlerini tamamlamadan doğdukları için tüm sistemleri immatürdür. Buna bağlı olarak da pek çok sorunları bulunmakta olup nörolojik komplikasyonlar açısından risk altındadır. Günümüzde, intraventriküler kanamanın önlenmesi veya kanamanın ilerlemesinin durdurulması için herhangi bir tedavi bulunmaması doğum öncesinde, doğum sırasında ve yenidoğan yoğun bakım ünitesinde uygulanabilecek koruyucu yaklaşımların önemini arttırmaktadır. Bu nedenle yenidoğanın beyin gelişimini korumak ve desteklemek amacıyla yenidoğan yoğun bakım ünitelerinde kapsamlı ve planlı bir nöroprotektif bakımın sunulması önem taşımaktadır. Nöroprotektif bakım, hemşirelerin yenidoğanın fizyolojik stabilitesini sağlamak üzere hemodinami, ventilasyon, sıvı ve nutrisyonel destek yönetimi alanlarında uyguladıkları girişimleri, yenidoğanın gelişimsel ihtiyaçlarını karşılayacak şekilde bütünleştirilmiş gelişimsel bakım çerçevesinde sunmalarını gerektirmektedir. Bu derleme, yenidoğan yoğun bakım ünitelerinde hemşirelerin intraventriküler kanamaların önlenmesinde nöroprotektif ve bütünleştirilmiş gelişimsel bakım sağlamadaki rollerini detaylı bir şekilde ele almaktadır. Hemşirelerin bu alandaki rolleri, yenidoğanların sağlıklı bir şekilde gelişimlerini sürdürebilmeleri için hayati bir öneme sahiptir.

Anahtar Kelimeler

İntraventriküler kanama, Nöroprotektif bakım, Prematüre, Yoğun bakım

Intraventricular Hemorrhage in Premature Infants: Risk Factors, Preventive Strategies, and Neuroprotective Nursing Care

Öz

Intraventricular hemorrhage is a serious complication that can impair neurological development in newborns. It often occurs within the first 72 hours after birth in premature infants and can lead to serious neurological outcomes such as hydrocephalus, cerebral palsy, and mental retardation by damaging brain tissue. Premature infants are born before completing their intrauterine development, thus all their systems are immature. Consequently, they are at risk for many problems, especially neurological complications. Currently, the lack of any treatment to prevent or halt the progression of intraventricular hemorrhage emphasizes the importance of preventive approaches that can be applied before birth, during delivery, and in the neonatal intensive care unit. Therefore, providing comprehensive and planned neuroprotective care in neonatal intensive care units is important to preserve and support the brain development of newborns. Neuroprotective care necessitates nurses to implement interventions in the areas of hemodynamics, ventilation, fluid, and nutritional support management to ensure the physiological stability of the newborn. This review extensively examines the roles of nurses in neonatal intensive care units in providing neuroprotective and integrated developmental care for the prevention of intraventricular hemorrhages. The roles of nurses in this field are crucial for the newborns to sustain healthy development.

Anahtar Kelimeler

Intraventricular hemorrhage, neuroprotective care, premature, intensive care

Kaynakça

• Akman, İ., Galip, N. (2011). Pretermde germinal matriks intraventriküler kanama. İstanbul Tıp Fakültesi Dergisi, 74(2), 43-46.
• Al-Abdi, S. Y., Al-Aamri, M. A. (2014). A systematic review and meta-analysis of the timing of early intraventricular hemorrhage in preterm neonates: clinical and research implications. Journal of Clinical Neonatology, 3(2), 76-88. doi: 10.4103/2249-4847.
• Altimier, L. (2011). Mother and child integrative developmental care model: A simple approach to a complex population. Newborn and Infant Nursing Reviews, 11(3), 105-108. doi: 10.1053/j.nainr.2011.06.004
• Altimier, L., Phillips, R. (2016). The neonatal integrative developmental care model: advanced clinical applications of the seven core measures for neuroprotective family-centered developmental care. Newborn and Infant Nursing Reviews, 16(4), 230-244. doi: 10.1053/j.nainr.2016.09.030
• Altimier, L., Phillips, R. M. (2013). The neonatal integrative developmental care model: Seven neuroprotective core measures for family-centered developmental care. Newborn and Infant Nursing Reviews, 13(1), 9-22. doi: 10.1053/j.nainr.2012.12.002
• Avazeh, M., Babaei, N. (2023). The Necessity of Implementing Clustered Care in Preterm Infants. International Journal of Community Based Nursing and Midwifery, 11(2), 149-150. doi: 10.30476/IJCBNM.2023.97945.2218
• Ballabh, P. (2014). Pathogenesis and prevention of intraventricular hemorrhage. Clinics in Perinatology, 41(1), 47-67. doi:10.1016/j.clp.2013.09.007
• Bassan, H. (2009). Intracranial hemorrhage in the preterm infant: understanding it, preventing it. Clinics in Perinatology, 36(4), 737-762. doi: 10.1016/j.clp.2009.07.014
• Choi, E. K., Kim, H. J., Je, B. K., Choi, B. M., Kim, S. D. (2023). Morbidity and mortality trends in preterm infants of <32 weeks gestational age with severe intraventricular hemorrhage: A 14-year single-center retrospective study. Journal of Korean Neurosurgical Society, 66(3), 316-323. doi: 10.3340/jkns.2022.0264
• Craig, J. W., Glick, C., Phillips, R., Hall, S. L., Smith, J., Browne, J. (2015). Recommendations for involving the family in developmental care of the NICU baby. Journal of Perinatology, 35 Suppl 1(Suppl 1), S5-S8. doi:10.1038/jp.2015.142
• Craig, J. W., Smith, C. R. (2020). Risk-adjusted/neuroprotective care services in the NICU: the elemental role of the neonatal therapist. Journal of Perinatology, 40(4), 549-559. doi: 10.1038/s41372-020-0597-1
• El Amouri, S., Bystricka, A., Paulose, A., Qadir, M., Khan, J. M. (2021). Reducing intraventricular hemorrhage in preterm babies less than 30 weeks of gestation in neonatal intensive care unit, level III: A bundle of care. Journal of Clinical Neonatology, 10(3), 165-169. doi: 10.4103/jcn.jcn_213_20
• Galderisi, A., Zammataro, L., Losiouk, E., Lanzola, G., Kraemer, K., Facchinetti, A., … Steil, G. M. (2019). Continuous glucose monitoring linked to an artificial ıntelligence risk ındex: early footprints of ıntraventricular hemorrhage in preterm neonates. Diabetes Technology & Therapeutics, 21(3), 146-153. doi: 10.1089/dia.2018.0383
• Garvey, A. A., Walsh, B. H., Inder, T. E. (2022). Pathogenesis and prevention of intraventricular hemorrhage. Seminars in Perinatology, 46(5), 151592. doi: 10.1016/j.semperi.2022.151592
• Gross, M., Engel, C., Trotter, A. (2021). Evaluating the effect of a neonatal care bundle for the prevention of intraventricular hemorrhage in preterm infants. Children, 8(4), 257. doi: 10.3390/children8040257
• Handley, S. C., Passarella, M., Lee, H. C., Lorch, S. A. (2018). Incidence trends and risk factor variation in severe intraventricular hemorrhage across a population based cohort. The Journal of Pediatrics, 200, 24-29. doi: 10.1016/j.jpeds.2018.04.020
• Héon, M., Aita, M., Lavallée, A., De Clifford-Faugère, G., Laporte, G., Boisvert, A., … Feeley, N. (2022). Comprehensive mapping of NICU developmental care nursing interventions and related sensitive outcome indicators: A scoping review protocol. BMJ Open, 12(1), e046807. doi: 10.1136/bmjopen-2020-046807
• Hwang-Bo, S., Seo, Y. M., Oh, M. Y., Im, S. A., Youn, Y. A. (2022). The prognosis of refractory hypotension and severe intraventricular hemorrhage in very low birth weight infants. Medicine, 101(30), e29598. doi: 10.1097/MD.0000000000029598
• Jiang, L., Yu, Q., Wang, F., Wu, M., Liu, F., Fu, M., Gao, J., Feng, X., Zhang, L., & Xu, Z. (2023). The role of blood pressure variability indicators combined with cerebral blood flow parameters in predicting intraventricular hemorrhage in very low birth weight preterm infants. Frontiers in Pediatrics, 11(1), 1241809. doi: 10.3389/fped.2023.1241809
• Kochan, M., Leonardi, B., Firestine, A., McPadden, J., Cobb, D., Shah, T. A., … Bass, W. T. (2019). Elevated midline head positioning of extremely low birth weight infants: effects on cardiopulmonary function and the incidence of periventricular-intraventricular hemorrhage. Journal of Perinatology, 39(1), 54-62. doi: 10.1038/s41372-018-0261-1
• Kramer, K. P., Minot, K., Butler, C., Haynes, K., Mason, A., Nguyen, L., … Rogers, E. E. (2022). Reduction of severe intraventricular hemorrhage in preterm infants: A quality improvement project. Pediatrics, 149(3), e2021050652. doi: 10.1542/peds.2021-050652
• Lim, J., Hagen, E. (2019). Reducing germinal matrix-ıntraventricular hemorrhage: Perinatal and delivery room factors. NeoReviews, 20(8), e452-e463. doi: 10.1542/neo.20-8-e452
• Limperopoulos, C., Gauvreau, K. K., O'Leary, H., Moore, M., Bassan, H., Eichenwald, E. C., … du Plessis, A. J. (2008). Cerebral hemodynamic changes during intensive care of preterm infants. Pediatrics, 122(5), e1006-e1013. doi: 10.1542/peds.2008-0768
• Lu, H., Wang, Q., Lu, J., Zhang, Q., Kumar, P. (2016). Risk factors for intraventricular hemorrhage in preterm infants born at 34 weeks of gestation or less following preterm premature rupture of membranes. Journal of Stroke and Cerebrovascular Diseases, 25(4), 807-812. doi:10.1016/j.jstrokecerebrovasdis.2015.12.011
• McCrea, H. J., Ment, L. R. (2008). The diagnosis, management, and postnatal prevention of intraventricular hemorrhage in the preterm neonate. Clinics in Perinatology, 35(4), 777-792. doi: 10.1016/j.clp.2008.07.014
• McGrath, J. M., Cone, S., Samra, H. A. (2011). Neuroprotection in the preterm infant: further understanding of the short-and long-term implications for brain development. Newborn and Infant Nursing Reviews, 11(3), 109-112. doi: 10.1053/j.nainr.2011.07.002
• Molloy, E. J., El-Dib, M., Soul, J., Juul, S., Gunn, A. J., Bender, M., … Newborn Brain Society Guidelines and Publications Committee (2023). Neuroprotective therapies in the NICU in preterm infants: present and future. Pediatric Research, 93(7):1819-1827. doi:10.1038/s41390-022-02295-2
• Özek, E., Kersin, S.G. (2020). Prematürede intraventriküler kanama. Türk Pediatri Arşivi, 55(3), 215-221. doi:10.14744/TurkPediatriArs.2020.66742
• Persad, N., Kelly, E., Amaral, N., Neish, A., Cheng, C., Fan, C. S., … Shah, V. (2021). Impact of a "brain protection bundle" in reducing severe intraventricular hemorrhage in preterm infants <30 weeks GA: A retrospective single centre study. Children (Basel, Switzerland), 8(11), 983-996. doi: 10.3390/children8110983
• Razak, A., Patel, W., Durrani, N. U. R., Pullattayil, A. K. (2023). Interventions to reduce severe brain injury risk in preterm neonates: A systematic review and meta-analysis. JAMA Network Open, 6(4), e237473. doi: 10.1001/jamanetworkopen.2023.7473
• Romantsik, O., Bruschettini, M., Moreira, A., Thébaud, B., Ley, D. (2019). Stem cell-based interventions for the prevention and treatment of germinal matrix-intraventricular haemorrhage in preterm infants. The Cochrane Database of Systematic Reviews, 9(9), CD013201. doi: 10.1002/14651858.CD013201.pub2
• Romantsik, O., Calevo, M. G., Bruschettini, M. (2020). Head midline position for preventing the occurrence or extension of germinal matrix-intraventricular haemorrhage in preterm infants. The Cochrane Database of Systematic Reviews, 7(7), CD012362. doi: 10.1002/14651858.CD012362.pub3
• Schmid, M. B., Reister, F., Mayer, B., Hopfner, R. J., Fuchs, H., Hummler, H. D. (2013). Prospective risk factor monitoring reduces intracranial hemorrhage rates in preterm infants. Deutsches Arzteblatt International, 110(29-30), 489-496. doi: 10.3238/arztebl.2013.0489
• Schulz, G., Keller, E., Haensse, D., Arlettaz, R., Bucher, H. U., Fauchère, J. C. (2003). Slow blood sampling from an umbilical artery catheter prevents a decrease in cerebral oxygenation in the preterm newborn. Pediatrics, 111(1), e73-e76. doi: 10.1542/peds.111.1.e73
• Shipley, L., Gyorkos, T., Dorling, J., Tata, L. J., Szatkowski, L., Sharkey, D. (2019). Risk of severe intraventricular hemorrhage in the first week of life in preterm infants transported before 72 hours of age. Pediatric Critical Care Medicine, 20(7), 638-644. doi: 10.1097/PCC.0000000000001937
• Simovic, A., Kuc, A., Jevtic, E., Kocovic, A., Markovic, S., Stanojevic, M., … Jeremic, D. (2021). Can early hyperglycemia affect the morbidity/mortality of very low birth weight premature infants?. The Turkish Journal of Pediatrics, 63(3), 482-489. doi: 10.24953/turkjped.2021.03.015
• Stocchetti, N., Taccone, F. S., Citerio, G., Pepe, P. E., Le Roux, P. D., Oddo, M., ... Vincent, J. L. (2015). Neuroprotection in acute brain injury: an up-to-date review. Critical Care, 19(1):186. doi: 10.1186/s13054-015-0887-8
• Stoll, B. J., Hansen, N. I., Bell, E. F., Walsh, M. C., Carlo, W. A., Shankaran, S., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2015). Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA, 314(10), 1039-1051. doi: 10.1001/jama.2015.10244
• Su, B. H., Hsieh, W. S., Hsu, C. H., Chang, J. H., Lien, R., Lin, C. H., … Premature baby foundation of Taiwan (PBFT) (2015). Neonatal outcomes of extremely preterm infants from taiwan: comparison with Canada, Japan, and the USA. Pediatrics and Neonatology, 56(1), 46-52. doi: 10.1016/j.pedneo.2014.05.002
• Tsao, P. C. (2023). Pathogenesis and prevention of intraventricular hemorrhage in preterm infants. Journal of Korean Neurosurgical Society, 66(3), 228-238. doi: 10.3340/jkns.2022.0288
• Türk Neonatoloji Derneği, Germinal Matriks Kanaması-İntraventriküler Kanama ve Komplikasyonlarının Tanı ve Yönetimi Rehberi 2021. Erişim tarihi: 22.01.2024, https://neonatology.org.tr/uploads/content/tanı-tedavi/8_min_min.pdf
• Wallau, C. A. K., Costa-Nobre, D. T., Leslie, A. T. F. S., Guinsburg, R. (2021). Impact of bundle implementation on the incidence of peri/intraventricular hemorrhage among preterm infants: a pre-post interventional study. Sao Paulo Medical Journal, 139(3), 251-258. doi: 10.1590/1516-3180.2020.0412.R1.28012021
• Weinstein, R. M., Parkinson, C., Everett, A. D., Graham, E. M., Vaidya, D., Northington, F. J. (2022). A predictive clinical model for moderate to severe intraventricular hemorrhage in very low birth weight infants. Journal Of Perinatology, 42(10), 1374-1379. doi:10.1038/s41372-022-01435-0
• Wu, T., Wang, Y., Xiong, T., Huang, S., Tian, T., Tang, J., … Mu, D. (2020). Risk factors for the deterioration of periventricular-intraventricular hemorrhage in preterm infants. Scientific Reports, 10(1), 13609. doi: 10.1038/s41598-020-70603-z
• Zhao, Y., Zhang, W., Tian, X. (2022). Analysis of risk factors of early intraventricular hemorrhage in very-low-birth-weight premature infants: a single center retrospective study. BMC Pregnancy and Childbirth, 22(1), 890-898. doi: 10.1186/s12884-022-05245-2
• Zhou, M., Wang, S., Zhang, T., Duan, S., Wang, H. (2023). Neurodevelopmental outcomes in preterm or low birth weight infants with germinal matrix-intraventricular hemorrhage: a meta-analysis. Pediatric Research, 1-9. doi: 10.1038/s41390-023-02877-8