Haemodynamic effects of differing blood transfusion rates in infants less than 1500 g.
OBJECTIVE
To investigate whether the haemodynamic effects of the standard 2-3 h blood transfusion increases the risk for intraventricular haemorrhage (IVH) and patent ductus arteriosus (PDA) in very low birthweight infants.


METHODS
In a randomized controlled study, haemodynamic changes using slow and rapid transfusion were compared. Twenty-seven very low birthweight infants were divided between 12h (n = 14) and 3h (n = 13) transfusion groups. Blood pressure, ejection fraction (EF), anterior cerebral artery pulsatility index (PI), blood gases, serum electrolytes and haematocrit were measured pre- and post-transfusion. Infectious status was also monitored.


RESULTS
Blood pressure (48.1/25.5 vs 55.7/30.2 mmHg) and EF (0.68 vs 0.73) increased significantly during rapid transfusion (P<0.01) but remained stable with slow transfusion. Serum potassium, base excess and incidence of infection did not increase in either group.


CONCLUSIONS
Slow transfusion causes less haemodynamic disturbance than rapid transfusion, thereby preventing the potential risk for IVH and PDA.
Nosè
Y
Y
Department of Paediatrics, Chulalongkorn Hospital and University, Bangkok, Thailand.
Tamai
H
H
Shimada
S
S
Funato
M
M
D001803:Blood Transfusion / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000209:etiology; D002552:Cerebral Ventricles; D004374:Ductus Arteriosus, Patent / Q000209:etiology; D006400:Hematocrit; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D011446:Prospective Studies; D013997:Time Factors; D065227:Transfusion Reaction