Haemodynamic effects of erythrocyte transfusion in preterm infants

The aim of the study was to assess the short-term cardiorespiratory effects of a standard red cell transfusion in very low birth weight (< 1500 g) infants undergoing intensive care. A total of 37 infants (birth weight 920 +/- 230 g, gestational age 27.8 +/- 2.1 weeks, age at study 6.1 +/- 3.9 days) with indwelling arterial lines were studied when 10 ml/kg of packed donor red cells were transfused based on clinical judgment. Infants with patent ductus arteriosus and/or inotropic treatment were excluded from the study. Oxygen saturation, left ventricular output, stroke volume, systolic, diastolic and mean arterial pressure, heart rate, and capillary refill time were assessed immediately prior to the transfusion and within an hour after the transfusion was completed. Capillary refill time after the transfusion was significantly shorter than prior to the transfusion (2.1 +/- 0.9 versus 2.4 +/- 1.0 s, P = 0.033). Left ventricular output, stroke volume and arterial pressures remained unaltered. Oxygen saturation after the transfusion was lower than before the transfusion (94.0 +/- 3.8 versus 95.3 +/- 2.5%, P = 0.014) despite unaltered oxygen supply.

the data suggest that although a red cell transfusion of 10 ml/kg may marginally improve peripheral perfusion, it does not influence cardiac output and arterial blood pressure in normotensive preterm infants. It may, however, cause a transient decrease in oxygen saturation.