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[Acid-base balance during exchange transfusion (author's transl)]
Padiatrie Und Padologie
|January 1, 1977
Summary
Exchange transfusion with acid citrate dextrose (ACD) blood can cause severe metabolic acidosis in newborns. Preterm infants and those with respiratory distress have reduced compensation, increasing complication risks. TRIS buffering is recommended to prevent acidosis.
Area of Science:
- Neonatal physiology
- Acid-base balance
- Blood product safety
Context:
- Exchange transfusion is a critical neonatal procedure.
- Acid citrate dextrose (ACD) blood is commonly used.
- Metabolic acidosis is a potential complication.
Purpose:
- To investigate the risk of metabolic acidosis during exchange transfusion with ACD blood.
- To evaluate the compensatory mechanisms in newborns.
- To recommend preventative strategies.
Summary:
- ACD blood's acidity increases with storage age.
- Mature newborns can compensate for acidosis via lungs, kidneys, and citrate metabolism.
- Preterm infants and those with respiratory distress or on mechanical ventilation have impaired compensatory mechanisms, increasing risk.
Impact:
- Highlights the potential dangers of ACD blood in vulnerable neonates.
- Emphasizes the need for careful monitoring during exchange transfusions.
- Recommends TRIS buffering as a preventative measure against acidosis.