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Sodium supply from administered blood products was associated with severe intraventricular haemorrhage in extremely

Cornelia Späth1, Elisabeth Stoltz Sjöström2, Johan Ågren3

  • 1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|May 26, 2022
PubMed

Insights

Sodium-rich blood product transfusions may increase the risk of severe intraventricular haemorrhage (IVH) in extremely preterm (EPT) infants. Higher sodium and fluid intake from transfusions, not plasma levels, correlated with IVH.

Area of Science:

  • Neonatalogy
  • Pediatric Cardiology
  • Critical Care Medicine

Background:

  • Severe intraventricular haemorrhage (IVH) is a significant complication in extremely preterm (EPT) infants.
  • The role of sodium and fluid balance in the development of IVH is not fully understood.
  • Understanding these associations is crucial for improving outcomes in EPT infants.

Purpose of the Study:

  • To investigate the relationship between sodium supply, fluid volume, and sodium imbalances with severe IVH in EPT infants.
  • To identify potential risk factors contributing to IVH in this vulnerable population.

Main Methods:

  • A nested case-control study was conducted using data from the EXtremely PREterm infants in Sweden Study (EXPRESS) cohort.
  • 70 case-control pairs of EPT infants (born 22-26 weeks gestation) were analyzed, matched for key demographic and clinical factors.
  • Infants with severe IVH (grade 3 or periventricular hemorrhagic infarction) were compared to IVH-free controls.

Main Results:

  • Infants with severe IVH received higher total sodium and fluid volumes, primarily from transfused blood products.
  • Daily total sodium supply until postnatal Day 2 was significantly higher in the severe IVH group (5.49 ± 2.53 mmol/kg/day) compared to controls (3.95 ± 1.91 mmol/kg/day).
  • High plasma sodium concentrations or significant sodium fluctuations were not associated with severe IVH.

Conclusions:

  • Results suggest a link between sodium-rich transfusions of blood products and severe IVH in EPT infants.
  • The exact mechanism remains unclear, potentially involving sodium load, volume load, or other transfusion-related factors.
  • Further research is needed to elucidate the specific causative factors and guide clinical practice.
Abstract

Keywords:
intraventricular haemorrhagepreterm infantssodium imbalancessodium supplytransfusions

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