Hemodynamic effects of red blood cell transfusion in patients with hemato-oncologic diseases

The hemodynamic effects of red blood cell (RBC) transfusion in patients with hemato-oncologic diseases can be adverse. We measured acute hemodynamic changes with a novel non-invasive monitoring device.

Twenty-six patients (9 female, 17 male; median age 73) with hematological malignancies or solid tumors were included. Peripheral and central hemodynamics were assessed before and after RBC transfusion using the VascAssist2.0 device.

Baseline hemoglobin was 7.8 g/dL (range 6.2-8.7). Post-transfusion, significant hemodynamic changes were observed: heart rate decreased from 81 to 74 bpm (p < 0.0001). Both brachial and aortic systolic and diastolic blood pressures increased significantly (brachial SBP: 123-128 mmHg, p = 0.001; aortic SBP: 101-109 mmHg, p = 0.0003; brachial DBP: 62-64 mmHg, p = 0.01; aortic DBP: 61-64 mmHg, p = 0.02). The augmentation index adjusted to 75 bpm (AIx75) also rose significantly (11-18%, p = 0.003). There were non-significant trends toward decreased aortic pulse wave velocity (p = 0.09) and increased estimated blood viscosity (p = 0.053), indicating possible beneficial rheological effects.

RBC transfusion in patients with hemato-oncologic diseases resulted in significant increases in central and peripheral blood pressures and a reduction in heart rate in our pilot study. Trends toward improved blood rheology and vascular function were observed, though not statistically significant. While these immediate hemodynamic effects appear beneficial, further research is needed to determine long-term outcomes, especially for patients requiring frequent transfusions.