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Effect of blood transfusion on acid base, glucose and electrolyte status in very low birth weight infants
Insights
Citrate phosphate dextrose (CPD) blood transfusions are generally well-tolerated by very low birth weight (VLBW) infants. While minor, insignificant changes in electrolytes and gases were noted, VLBW infants showed no significant adverse effects from CPD transfusions.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Clinical Biochemistry
Background:
- Very low birth weight (VLBW) infants often require blood transfusions.
- Citrate phosphate dextrose (CPD) is a common anticoagulant preservative used in stored blood.
- The physiological impact of CPD blood transfusions on vulnerable VLBW infants requires careful evaluation.
Purpose of the Study:
- To investigate the effects of CPD blood transfusions on acid-base balance, glucose levels, and electrolyte status in VLBW infants.
- To assess the safety and tolerance of CPD transfusions across different age groups and with repeat transfusions in VLBW infants.
Main Methods:
- Study included VLBW infants categorized into four groups based on age (1-7 days, 8-20 days, >20 days) and transfusion history (primary or repeat).
- Acid-base parameters, glucose, and electrolytes (including ionic calcium) were monitored during and after CPD blood transfusions.
- Clinical well-being of infants was assessed throughout the transfusion process.
Main Results:
- VLBW infants in the 1-7 day age group showed a significant decrease in ionic calcium and PO2.
- No other significant changes in acid-base status, glucose, or other electrolytes were observed across all groups.
- Observed changes were less pronounced with increasing infant age and with repeat transfusions, indicating good tolerance.
Conclusions:
- VLBW infants generally tolerate CPD blood transfusions well, with minimal physiological disturbances.
- The most notable effect observed was a transient drop in ionic calcium and PO2 in the youngest infants (1-7 days).
- Age and repeat transfusions appear to mitigate any minor physiological effects, supporting the safety of CPD use in this population.
Abstract:
The effect of citrate phosphate dextrose (CPD) blood transfusion on the acid base, glucose and electrolyte status of VLBW infants was studied in infants aged 1-7, 8-20 and greater than 20 days; a 4th group composed of infants greater than 20 days subjected to a second transfusion was also studied. All the infants remained clinically well during and after the transfusion. Only the infants in the group 1-7 days experienced a significant fall in ionic Ca and PO2. No significant change in all the other parameters studied was observed. In the other groups of infants studied, the changes observed were not significant, and became less with increasing age and repeat transfusion. VLBW infants apparently tolerate CPD blood transfusion well.