Document Detail


Effects of red blood cell transfusions during the first week of life on acid-base, glucose, and electrolytes in preterm neonates.
MedLine Citation:
PMID:  18647369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: More than 90 percent of extremely low-birth-weight infants receive one or more transfusions of red blood cells (RBCs). The objective was to assess if RBC transfusions may induce significant changes of plasma acid-base, electrolyte, and glucose status in extremely preterm infants. STUDY DESIGN AND METHODS: Records of infants with gestational age of less than 31 weeks who were transfused with RBCs during the first week of life were reviewed (n = 61). Blood samples were collected from infants before and after transfusions to evaluate hemoglobin (Hb) level, hematocrit, acid-base, electrolyte, and glucose status. Then infants were stratified into four groups that received a RBC volume of less than 15, 15 to 20, more than 20 to 25, or more than 25 mL per kg. RESULTS: Infants received 20.7 (+/-1.5) mL per kg RBCs. After transfusions, a significant increase of pO(2) (p < 0.0001) and decrease of Ca(2+) (p = 0.047) and glycemia (p < 0.0001) were observed. Infants who were transfused with more than 25 mL per kg were significantly less immature, heavier, and more anemic than infants in other groups. A positive relationship was found between changes of patients' potassium plasma level and K(+) intake through RBC transfusion (r = 0.442, p = 0.008). Three (4.9%) infants developed hyperkalemia, one (1.6%) had an exacerbation of his hypocalcemia, and another (1.6%) of his hypoglycemia. CONCLUSIONS: RBC transfusions were effective in correcting anemia in our patients and induced a slight increase of pH and pO(2) and decrease of Ca(2+) and glycemia, which were not clinically relevant. A linear direct correlation was observed between potassium intake by RBC transfusions and changes of kalemia in our infants, but there was not an increase of K(+) plasma level after transfusions.
Authors:
Carlo Dani; Silvia Perugi; Alessandra Benuzzi; Iuri Corsini; Giovanna Bertini; Simone Pratesi; Firmino F Rubaltelli
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Publication Detail:
Type:  Journal Article     Date:  2008-07-17
Journal Detail:
Title:  Transfusion     Volume:  48     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-04     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2302-7     Citation Subset:  IM    
Affiliation:
Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.it
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium*
Anemia / blood,  therapy*
Anoxia / blood,  therapy
Blood Glucose / analysis*
Electrolytes / blood*
Erythrocyte Transfusion* / adverse effects
Female
Gestational Age
Humans
Hyperkalemia / etiology
Hypocalcemia / etiology
Hypoglycemia / etiology
Infant, Newborn
Infant, Newborn, Diseases / blood,  therapy
Infant, Premature / blood*
Infant, Very Low Birth Weight / blood*
Male
Retrospective Studies
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Electrolytes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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