Risk Assessment of Red Cell Transfusion in Congenital Heart Disease

Area of Science:

• Pediatric critical care medicine
• Transfusion medicine
• Biochemistry

Background:

• Storage time of packed red blood cells (pRBC) correlates with changes in pH, potassium, and lactate.
• Blood-gas analysis is a bedside tool for assessing these parameters before transfusion.
• Understanding these changes is crucial for informed transfusion decisions in pediatric patients.

Purpose of the Study:

• To assess the impact of storage duration on pH, potassium, and lactate levels in pRBC.
• To evaluate the influence of these parameters on transfused children's blood gases.

Main Methods:

• Retrospective analysis of blood-gas analyses of pRBC units administered to neonates, infants, and children.
• Blood-gas analyses were performed on pRBC units before transfusion.
• Patients' blood gases were monitored before and after transfusion.

Main Results:

• A significant correlation was found between pRBC storage time and decreased pH, increased potassium, and increased lactate (p<0.0001).
• Median pRBC storage duration was 6 days.
• No statistically significant effect on children's blood gases was observed within 4 hours post-transfusion, regardless of storage duration (≤7 days or >7 days).

Conclusions:

• Stored red blood cells undergo rapid changes in pH, potassium, and lactate.
• Slow transfusion of pRBC units did not result in adverse effects on recipients' blood gas parameters.