title: Factors affecting efficacy of packed red blood cell transfusion in neonates.
abstract: The degree of increase in haematocrit and equilibration time following packed red blood cell (PRBC) transfusion in neonates is not well studied. We evaluated change in haematocrit 15 min, 6 h and 24 h after PRBC transfusion in neonates and factors predicting this change. Among neonates receiving PRBC transfusion, we recorded pre-transfusion haematocrit and a priori identified putative variables affecting change in haematocrit following transfusion. The factors affecting change in haematocrit were analyzed by multiple linear regression analysis. Eighty-one neonates received 119 PRBC transfusions (mean volume 16 ± 4 mL/kg). Haematocrit increased from 26 ± 5 to 41 ± 5% at 15 min after PRBC transfusion (p = 0.001) and remained stable till 6 h (41 ± 5%, p = 0.11). It decreased to 40 ± 5%, at 24 h post transfusion (p < 0.001). On linear regression analysis, baseline haematocrit of the baby, donor blood haematocrit and volume of PRBC transfusion were independent determinants of increase in haematocrit.
  
  
  CONCLUSIONS
  After 16 mL/kg PRBC transfusion in neonates, haematocrit increased by 15% at 15 min post transfusion. The equilibration in haematocrit values was achieved by 15 min after transfusion. Baseline haematocrit of neonate, donor blood haematocrit and transfusion volume independently determine the rise in haematocrit. What is Known: • Rise in haematocrit following PRBC transfusion in neonates has been studied in a small number of stable infants. • Determinants of efficacy of PRBC transfusion have not been well studied in newborns. What is New: • Each milliliter/kilogramme of PRBC transfusion increases the neonate's haematocrit by approximately 1%. • Baseline haematocrit, donor blood haematocrit and transfusion volume per kilogramme body weight independently determine the rise in haematocrit.
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Rakesh Kumar
authors.initials: RK
authors.lastname: Pilania
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Shiv Sajan
authors.initials: SS
authors.lastname: Saini
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Sourabh
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Das
authors.affiliation: Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Marwaha
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. drpkumarpgi@gmail.com.
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
mesh_terms: D000704:Analysis of Variance; D001724:Birth Weight; D017707:Erythrocyte Transfusion / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D006400:Hematocrit / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors
keywords: Haematocrit; Neonate; Packed red blood cells; Transfusion