Evaluation of Transfusion-Related Hemodynamic Parameters in Patients with Beta-Thalassemia Major by Ambulatory Blood Pressure Monitoring Method
Evaluación de los parámetros hemodinámicos relacionados con la transfusión en pacientes con beta-talasemia mayor mediante el método de monitorización ambulatoria de la presión arterial
Melis Aydın Mut, Emine Türkkan, Hüseyin Dağ, Hasan Dursun
Abstract
Introduction: There are very few studies on the effects of regular blood transfusions on the hemodynamic organization of patients with Beta-Thalassemia Major (BTM). Ambulatory Blood Pressure Monitoring is method that evaluates fluctuations in day-night periods and life cycle changes. In this study, we aimed to investigate the effects of blood transfusion on hemodynamic parameters by the Ambulatory Blood Pressure Monitoring method on the day of transfusion in patients with a diagnosis of Beta-Thalassemia Major.
Material and Methods: This study was conducted in patients who were followed up with a diagnosis of BTM between June 2020 and July 2020. The study consisted of 30 patients. The blood pressure of the patients was measured by auscultation method on the morning of the day when they received routine red blood cell transfusion treatments, and the patients were fitted with an Ambulatory Blood Pressure Monitoring device. With Ambulatory Blood Pressure Monitoring, mean systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure, values were calculated for each patient. Statistical analysis was performed by the IBM SPSS Statistics 21 package program. The significance limit for the p-value was accepted as <0.05.
Results: There was a significant difference in mean systolic blood pressure and heart rate values between pre-transfusion, transfusion, and post-transfusion periods. In our study, the rate of white coat hypertension was 8.3%, and the rate of masked hypertension was 4.1%. It was observed that 67% of the patients were non-dippers, and the blood pressure burden of one patient was more than 25%.
Conclusions: Measurement of hemodynamic parameters with Ambulatory Blood Pressure Monitoring is the gold standard in terms of detection and follow-up of non-dipper patients, indicating increased cardiovascular risk. In practice, Ambulatory Blood Pressure Monitoring should be used more in the follow-up of chronic patients.
Keywords
Resumen
Introducción: Existen muy pocos estudios sobre los efectos de las transfusiones de sangre periódicas sobre la organización hemodinámica de los pacientes con Beta-Talasemia Mayor (BTM). La monitorización ambulatoria de la presión arterial es un método que evalúa las fluctuaciones en los períodos diurnos y nocturnos y los cambios en el ciclo de vida. En este estudio, nuestro objetivo fue investigar los efectos de la transfusión de sangre sobre los parámetros hemodinámicos mediante el método de Monitoreo Ambulatorio de la Presión Arterial el día de la transfusión en pacientes con diagnóstico de Beta-Talasemia Mayor.
Material y métodos: Este estudio se realizó en pacientes que fueron seguidos con un diagnóstico de BTM entre junio de 2020 y julio de 2020. El estudio consistió en 30 pacientes. La presión arterial de los pacientes se midió mediante el método de auscultación en la mañana del día en que recibieron los tratamientos de transfusión de glóbulos rojos de manera rutinaria, y los pacientes fueron equipados con un dispositivo de monitoreo ambulatorio de la presión arterial. Con la monitorización ambulatoria de la presión arterial, se calcularon los valores de la presión arterial sistólica media, la presión arterial diastólica, la frecuencia cardíaca y la presión arterial media de cada paciente. El análisis estadístico se realizó mediante el programa de paquete IBM SPSS Statistics 21. El límite de significación para el valor p se aceptó como <0,05.
Resultados: Hubo una diferencia significativa en la presión arterial sistólica media y los valores de frecuencia cardíaca entre los períodos de pretransfusión, transfusión y postransfusión. En nuestro estudio, la tasa de hipertensión de bata blanca fue del 8,3% y la tasa de hipertensión enmascarada fue del 4,1%. Se observó que el 67% de los pacientes eran no dippers y la carga de presión arterial de un paciente era superior al 25%.
Conclusiones: La medición de parámetros hemodinámicos con monitorización ambulatoria de la presión arterial es el estándar de oro en términos de detección y seguimiento de pacientes no dipper, lo que indica un mayor riesgo cardiovascular. En la práctica, la monitorización ambulatoria de la presión arterial debería utilizarse más en el seguimiento de pacientes crónicos.
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Submitted date:
03/22/2021
Reviewed date:
04/19/2021
Accepted date:
04/24/2021
Publication date:
04/27/2021
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