Abstract
Background:
Little is known about the change in circulating red cell volume (RCV) of very-low-birth-weight (VLBW) infants during the first weeks of life.
Methods:
RCV was measured during the first 5 d in 35 VLBW infants using chromium-51 labeling of the infants’ red blood cells (RBCs). RCV was measured again at 6 wk of age in 12 infants, and the volumes of RBCs lost by phlebotomy and those gained by transfusion were recorded between the RCV measurements. In six infants, the volume of waste blood on materials contaminated with blood during phlebotomy, which would usually be discarded, was measured by radioactive counting.
Results:
The mean RCV in the first several days of life was 39.6 ml (35.7 ml/kg; range: 20.1–58.7 ml/kg). Of the 12 infants whose RCV was measured twice, all but one had a decrease in absolute RCV. The mean RCV initially and at 6 wk were 37.3 and 26.6 ml, respectively. The mean volume of RBCs lost through phlebotomy was 29.2 ml, and the mean volume of RBCs given by transfusion was 34.5 ml.
Conclusion:
During the first 6 wk of life, when the anemia of prematurity is evolving, the RCV falls despite complete replacement of RBCs lost by diagnostic phlebotomy with transfused RBCs.
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Acknowledgements
Red cell volume measurements from some of the patients included in this series were also included in a previous non–peer-reviewed publication (Blanchette VS, Zipursky A. Clin Perinatol. 1984;11:489), which did not address the central theme of this report, the change in red cell volume over time and the red cell balance during evolution of anemia of prematurity.
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Bell, E., Nahmias, C., Sinclair, J. et al. Changes in circulating red cell volume during the first 6 weeks of life in very-low-birth-weight infants. Pediatr Res 75, 81–84 (2014). https://doi.org/10.1038/pr.2013.183
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DOI: https://doi.org/10.1038/pr.2013.183
