Effects of increased red cell mass on subclinical tissue acidosis in hyaline membrane disease.
OBJECTIVE
To determine whether there are subclinical deficits in oxygen delivery in ventilated premature neonates.


METHODS
Ventilated premature neonates weighing less than 1500 g, who were transfused for anaemia or who were given colloids for clotting abnormalities (or oedema), were haemodynamically monitored during the first week of life. Calf muscle surface pH (pH) was measured in conjunction with peripheral limb blood flow by occlusion plethysmography.


RESULTS
Packed red blood cell transfusions corrected a subclinical regional tissue acidosis (low tpH) without affecting arterial pH or limb blood flow. This observation also correlated with an increase in regional oxygen delivery. The data were also suggestive of a pattern of pathological, supply dependent, oxygen delivery and are similar to other observations made in adults with adult respiratory distress syndrome.


CONCLUSIONS
Packed red blood cells increase regional oxygen delivery and tissue surface pH. In contrast, colloid infusion provided no substantial cardiovascular or metabolic benefit to these patients and should be avoided when oxygen delivery is at issue and when there may be leaky pulmonary capillaries.
La Gamma
E F
EF
Department of Pediatrics, University at Stony Brook, New York 11794-8111, USA.
Krauss
A
A
Auld
P A
PA
D000138:Acidosis / Q000209:etiology / Q000628:therapy*; D003102:Colloids; D017707:Erythrocyte Transfusion; D006801:Humans; D006819:Hyaline Membrane Disease / Q000150:complications* / Q000503:physiopathology; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007866:Leg / Q000098:blood supply; D010101:Oxygen Consumption; D012039:Regional Blood Flow; D012121:Respiration, Artificial
D003102:Colloids