Abstract
No previous studies have evaluated the response of red cell volume (RCV) to blood transfusion (Tx) in hypotensive preterm infants. We measured RCV in 69 hypotensive infants with respiratory distress syndrome (RDS) using Tc-99m and 51 Cr red cell leveling. All patients received Tx in amounts estimated by initial RCV to be sufficient to restore the volume to normal (55-60 ml/kg). Following Tx, RCVs were repeated in 27 patients; 2-7 serial values were obtained.
Sixty-five infants responded to Tx with a rise in blood pressure (BP) and/or RCV; 4 had no rise in RCV (3 expired). Serial measurements in non-asphyxiated infants demonstrated a rise to expected RCV. However, the rise observed in asphyxiated preterm infants was disproportionate to the volume Tx, and only 37% of the Tx appeared in the circulating RCV, as shown in the table:
Conclusions: Asphyxiated preterm infants have RCVs lower than those born without asphyxia. Tx to all hypotensive preterm infants produces a rise in BP and/or RCV but infants subjected to asphyxia may sequester a portion of the Tx. We speculate that the hypotension observed in patients with RDS results from red cell sequestration as a result of perinatal asphyxia.
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Paxson, C., Dirksen, J. & Quaife, M. 644 RED CELL SEQUESTRATION IN PRETERM INFANTS. Pediatr Res 12 (Suppl 4), 471 (1978). https://doi.org/10.1203/00006450-197804001-00649
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DOI: https://doi.org/10.1203/00006450-197804001-00649
