Safety and efficacy of AS-1 red blood cell use in neonates.
Many Regional Blood Centers are providing AS-1(Adsol preservative) red blood cells (RBCs) as a standard product because of the extended shelf life (42 days). The use of AS-1 RBCs is concerning in neonates because of high exposure to dextrose, adenine and mannitol. We conducted this study to evaluate the safety and efficacy of AS-1 RBC use in neonates. We assigned one unit of AS-1 RBCs to each infant for small volume transfusions (15 ml/kg) for the life of the unit (42 days). The study was conducted for one year. The infants under 1500 g were included in the study. We measured the pre- and post-transfusion hematocrit, post-transfusion serum sodium, potassium, glucose, bilirubin and blood pH. We compared the average number of transfusions per patient and average blood donor exposure per patient using AS-1 RBC to CPDA-1 packed red blood cells (PRBC) use, data available for prior year. We monitored the blood transfusion reactions during the study period. The hematocrit increased significantly from 30.1 +/- 4.6 pre-transfusion to 38.3 +/- 4.9 post-transfusion. The post-transfusion serum bilirubin, blood pH, serum potassium, sodium and glucose remained within the normal range. In spite of an increase in the number of average transfusions per patient with AS-1 RBC (6.67 +/- 5.1), the average donor exposure (1.8 +/- 1.1) remained less than two donors. There were not any transfusion reactions reported during the study. In conclusion, the use of AS-1 red blood cells is safe for small volume transfusions in neonates.
Jain
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R
Department of Pediatrics, Loyola University Medical Center, Maywood, IL 60153, USA. rjain@luc.edu
Jarosz
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C
D000225:Adenine / Q000494:pharmacology*; D001793:Blood Preservation / Q000009:adverse effects / Q000379:methods / Q000592:standards; D002951:Citrates / Q000494:pharmacology; D003257:Consumer Product Safety; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D004912:Erythrocytes / Q000187:drug effects; D005947:Glucose / Q000494:pharmacology*; D006801:Humans; D007231:Infant, Newborn; D008353:Mannitol / Q000494:pharmacology*; D010710:Phosphates / Q000494:pharmacology; D011787:Quality of Health Care; D012965:Sodium Chloride / Q000494:pharmacology*
C037839:ADSOL; C034876:CPDA solutions; D002951:Citrates; D010710:Phosphates; D008353:Mannitol; D012965:Sodium Chloride; D005947:Glucose; D000225:Adenine