Yüksek riskli bebeklerde taburculuk sonrası respiratuvar sinsisyal virus pasif profilaksi önerilerine uyumun değerlendirilmesi
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bebeklik ve erken çocukluk döneminde alt solunum yolu enfeksiyonlarının önemli nedeni olan respiratuar sinsisyal virus (RSV) ülkemizin de bulunduğu kuzey yarıküredeki ılıman iklim kuşağında kış mevsiminde riskli gruplarda ölümle sonuçlanabilen ağır enfeksiyonlar yaratmakta ancak halen geliştirilmiş etkin bir aşı ile korunulamamaktadır. Ülkemizde iki yaşından küçük hastane yatışına yol açan alt solunum yolu enfeksiyonlarında RSV sıklığı %30-38 olarak saptanmaktadır. Palivizumab prematüre, prematüreliğe bağlı kronik akciğer hastalığı ve konjenital kalp hastalığı olan bebeklerde RSV enfeksiyonunun şiddetini hastaneye yatırma gereksinimi azaltmada etkili ve güvenilir bir monoklonal antikordur ve bu bebeklere RSV mevsiminde aylık intramusküler uygulamalar önerilir. Yüksek riskli bebeklerin uygun aralıklarla uygun dozda ve zamanda aldıkları palivizumab profilaksisi ile RSV enfeksiyonu ile karşılaştıklarında hastalığı daha hafif atlattığı ve yoğun bakım yatış gereksinimin azaltabileceği gösterilmiştir. Bu nedenle palivizumab profilaksi grubuna alınan bebeklerde profilaksi programına tam uyum önemlidir. Bu çalışmada Eylül 2013 Mart 2015 tarihleri arasında hastanemizde palivizumab profilaksi programına alınan olgular değerlendirildi. Çalışmaya katılım için ailelerinden bilgilendirilmiş onam alınan hastalar belli aralarla kontrola çağırıldı ve rutin kontrol ve gerekli takip ve aşılamaları yanında palivizumab profilaksileri yapıldı. Hastaların her kontrol önesi telefonla hatırlatmaları yapıldı. Çalışmaya alınan yüksek riskli bebeklerin profilaksi endikasyonu koyduran klinik tanılarına göre dağılımı prematüre bebekler % 20, prematüre ve bronkopulmoner displazili olan % 55,5 prematüre ve konjenital kalphastası olan % 7, siyonatik kalp hastalığı olan %14, asiyonotik kalp hastalığı olan % 3,5 idi. Planlanan dozların tamamını yaptırmak tam uyum olarak değerlendirildi. 200 hasta çalışmaya alındı çalışmaya alınan hastaların genel uyumu % 67.5 olarak diğer çalışmalardan daha yüksek bulundu. Profilaksi programına uyumun; gestasyonel yaş, profilaksi endikasyonu ve yenidoğan döneminde izlendiği merkez, aldığı solunum desteği gibi faktörlerden etkilenmediği görüldü. RSV Profilaksi programına alınan ailelerin broşür ve sözel olarak bilgilendirilmesi, bebeklerin uygulama zamanında sağlık kontrolü yapılması, telefonla randevunun hatırlatılması uyumun arttırılmasında önemlidir Çalışmamızda saptanan bu yüksek oranda bu faktörler önemli yer tutmaktadır.
Respiratory syncytial virus (RSV) can cause serious infections in infancy and early childhood, especially during the winter in northern hemisphere temperate climate zones, and therefore also in our country. It may even lead to death in high-risk groups. Unfortunately, there is no safe and effective vaccine prophylaxis. RSV incidence in patients below two years of age hospitalized due to lower respiratory tract infection is reported as 30-38% in our country. Palivizumab is an effective and safe monoclonal antibody against the severity of RSV infection in infants with premature, prematurity chronic pulmonary disease and congenital heart disease and monthly intramuscular administration of these infants is recommended during the RSV season. High-risk infants who have received appropriate doses and timely palivizumab prophylaxis at appropriate intervals have relieved the disease to a lesser extent when compared with RSV infection and It may reduce the need for intensive care hospitalization. Therefore, full compliance with the prophylaxis schedule is important in infants taken to the palivizumab prophylaxis group In this study, cases of palivizumab prophylaxis were evaluated in our hospital between September 2013 and March 2015. Patients who were informed of their families to participate in the study were called out for control. Routine control and necessary follow-up and immunization as well as palivizumab prophlaxy was done. Reminders were made on the phone every time the patients check-in. Distribution of high-risk infants according to clinical diagnoses that cause an indication for prophylaxis Premature infants were 20%, premature and bronchopulmonary dysplasia were 55,5% premature and congenital heart disease 7%, cyanotic heart disease 14%, and acyonotic heart disease 3,5%. Completion of the planned doses was evaluated as complete compliance. 200 patients were taken into the study The overall compliance of the patients to the study was 67.5% higher than the other studies. Adapt to the prophylaxis schedule; Gestational age, indications for prophylaxis and center of neonatal period, respiratory support received were not affected by such factors. Brochures and verbal information of the families, baby's health check at the time of application and appointment reminder is imporatnt to increase compliance to the prophylaxy. These factors play an important role in this high level of our work.
Respiratory syncytial virus (RSV) can cause serious infections in infancy and early childhood, especially during the winter in northern hemisphere temperate climate zones, and therefore also in our country. It may even lead to death in high-risk groups. Unfortunately, there is no safe and effective vaccine prophylaxis. RSV incidence in patients below two years of age hospitalized due to lower respiratory tract infection is reported as 30-38% in our country. Palivizumab is an effective and safe monoclonal antibody against the severity of RSV infection in infants with premature, prematurity chronic pulmonary disease and congenital heart disease and monthly intramuscular administration of these infants is recommended during the RSV season. High-risk infants who have received appropriate doses and timely palivizumab prophylaxis at appropriate intervals have relieved the disease to a lesser extent when compared with RSV infection and It may reduce the need for intensive care hospitalization. Therefore, full compliance with the prophylaxis schedule is important in infants taken to the palivizumab prophylaxis group In this study, cases of palivizumab prophylaxis were evaluated in our hospital between September 2013 and March 2015. Patients who were informed of their families to participate in the study were called out for control. Routine control and necessary follow-up and immunization as well as palivizumab prophlaxy was done. Reminders were made on the phone every time the patients check-in. Distribution of high-risk infants according to clinical diagnoses that cause an indication for prophylaxis Premature infants were 20%, premature and bronchopulmonary dysplasia were 55,5% premature and congenital heart disease 7%, cyanotic heart disease 14%, and acyonotic heart disease 3,5%. Completion of the planned doses was evaluated as complete compliance. 200 patients were taken into the study The overall compliance of the patients to the study was 67.5% higher than the other studies. Adapt to the prophylaxis schedule; Gestational age, indications for prophylaxis and center of neonatal period, respiratory support received were not affected by such factors. Brochures and verbal information of the families, baby's health check at the time of application and appointment reminder is imporatnt to increase compliance to the prophylaxy. These factors play an important role in this high level of our work.
