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Atrial natriuretic peptide and blood volume during red cell transfusion in preterm infants
1Department of Neonatology, Universitätskinderklinik, Heidelberg, Germany.
Insights
Slow red cell transfusion in preterm infants did not increase plasma atrial natriuretic peptide levels. This suggests that small transfusions do not cause significant volume expansion, impacting the cardiovascular system.
Area of Science:
- Neonatal physiology
- Cardiovascular research
- Hematology
Background:
- Elevated atrial natriuretic peptide (ANP) suggests volume expansion.
- Understanding fluid balance is crucial in preterm infants.
Purpose of the Study:
- To investigate the effect of red cell transfusion on ANP concentration in preterm infants.
- To assess changes in packed cell volume and intravascular volume post-transfusion.
Main Methods:
- Studied eight preterm infants undergoing red cell transfusion.
- Measured plasma ANP concentration, packed cell volume, and blood volume.
- Monitored urine output and sodium excretion.
Main Results:
- Red cell transfusion increased red cell mass and packed cell volume.
- Plasma volume decreased, but total blood volume remained unchanged.
- Plasma ANP concentration, urine flow, and urinary sodium excretion did not significantly change.
Conclusions:
- Slow transfusion of <10 ml red cells/kg does not induce volume expansion.
- This transfusion volume does not lead to subsequent ANP release.
- The cardiovascular system is not significantly affected by these small transfusions.
Abstract:
Because raised plasma concentrations of atrial natriuretic peptide indicate volume expansion, we studied the effect of red cell transfusion on plasma atrial natriuretic peptide concentration, packed cell volume, and intravascular volume in eight preterm infants. Red cell transfusion increased red cell mass, packed cell volume and erythrocyte count, but decreased plasma volume. Total blood volume, plasma atrial natriuretic peptide concentration, urine flow rate, and urinary sodium excretion did not change. We conclude that a slow transfusion of less than 10 ml red cells/kg body weight does not cause volume expansion with subsequent atrial natriuretic peptide release thereby affecting the cardiovascular system.