Document Detail

A mathematical modeling approach to quantify the role of phlebotomy losses and need for transfusions in neonatal anemia.
MedLine Citation:
PMID:  23033916     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Very preterm infants commonly develop anemia requiring multiple red blood cell transfusions (RBCTx). This is in part attributable to heavy laboratory phlebotomy loss. Quantification of the extent to which laboratory blood loss contributes to anemia sufficient to prompt RBCTx has not been examined.
STUDY DESIGN AND METHODS: Twenty-six preterm infants weighing less than 1500 g at birth requiring ventilator support who received one or more RBCTx were intensively studied during the first month of life. Hemoglobin (Hb) loss via laboratory blood loss and RBC senescence and Hb gain from RBCTx were precisely accounted for in a Hb mass balance mathematical model developed to assess the impact of phlebotomy on RBCTx when restrictive RBCTx criteria were applied.
RESULTS: Study subjects had a birth weight of 880 ± 240 g (mean ± SD) and a Hb level of 14.4 ± 2.4 g/dL at birth and received 3.81 ± 2.15 RBCTx during the study period. Modeling indicated that even with the total elimination of laboratory phlebotomy loss, a reduction of 41% to 48% in RBCTx was achievable.
CONCLUSION: The present modeling results indicate that while phlebotomy reduction can significantly decrease the number of RBCTx administered to preterm infants, total elimination of all RBCTx will likely require other approaches, for example, stimulation of erythropoiesis with erythropoiesis-stimulating agents.
Matthew R Rosebraugh; John A Widness; Demet Nalbant; Peter Veng-Pedersen
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-04
Journal Detail:
Title:  Transfusion     Volume:  53     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-11     Completed Date:  2013-08-12     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1353-60     Citation Subset:  IM    
Copyright Information:
© 2012 American Association of Blood Banks.
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MeSH Terms
Anemia, Neonatal / drug therapy,  physiopathology*,  therapy*
Birth Weight
Blood Transfusion*
Blood Volume / physiology
Blood Volume Determination / methods
Computer Simulation
Erythropoietin / therapeutic use
Hematinics / therapeutic use
Infant, Newborn
Infant, Premature / blood
Infant, Very Low Birth Weight / blood
Models, Cardiovascular*
Phlebotomy / adverse effects*
Grant Support
Reg. No./Substance:
0/Hematinics; 0/Hemoglobins; 11096-26-7/Erythropoietin

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

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