Document Detail


The value of capillary whole blood lactate for blood transfusion requirements in anaemia of prematurity.
MedLine Citation:
PMID:  11280639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the usefulness of blood lactate as an indication for blood transfusion in anaemia of prematurity by means of a study protocol which considers the site of blood sampling and the repeatability of lactate measurements. DESIGN: Prospective clinical study. SETTING: Multidisciplinary, neonatalpaediatric intensive care unit of a non-university, teaching children's hospital. PATIENTS AND METHODS: Comparison of pre- and 48-h post-transfusion capillary whole blood lactate in 18 anaemic premature babies. In 30 neonates the agreement between capillary and arterial lactate was analysed by using the Bland Altman plot. In 30 stable premature infants four capillary lactate measurements were carried out within 24 h and analysed with regard to variability (coefficient of variation (CV); association between SD and mean) and to establish normal values. RESULTS: In the transfused infants, haematocrit increased from 23 (SD 3)% to 37 (SD 3)%. Mean lactate decreased from 2.5 (SD 1.0) to 1.7 (SD 0.5) mmol/l (p = 0.003). Pretransfusion lactate did not correlate with pre-transfusion haematocrit, heart rate, respiratory rate, number of apnoeas/bradycardias and weight gain (multiple regression). The mean difference between capillary and arterial lactate was 0.17 (SD 0.24) mmol/l and the 95 % confidence interval (CI) was -0.31 to 0.65 mmol/l. The CV of repetitive measurements was 19.8 (SD 9.8)% and SD correlated positively with mean lactate values (p = 0.001); the 95 % CI (normal range for premature infants) was 1.56-1.90 mmol/l. CONCLUSIONS: Capillary whole blood lactate measurements in newborn babies agree excellently with arterial values. Lactate measurements add little information to the decision whether to transfuse or not, considering the variability of this parameter in stable premature infants and the lack of correlation with other possible clinical indicators of compromised oxygen delivery.
Authors:
B Frey; M Losa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  27     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-03-30     Completed Date:  2001-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  222-7     Citation Subset:  IM    
Affiliation:
Intensive Care Unit, Ostschweizer Kinderspital, Switzerland. Bernhard.Frey@kispi.unizh.ch
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MeSH Terms
Descriptor/Qualifier:
Anemia, Neonatal / diagnosis*,  therapy
Biological Markers / blood
Erythrocyte Transfusion*
Humans
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal
Lactic Acid / blood*
Linear Models
Multivariate Analysis
Prospective Studies
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Biological Markers; 50-21-5/Lactic Acid

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


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