Blood sampling in very low birth weight infants receiving different levels of intensive care

Abstract

Sixty very low birth weight infants (birth weight 560-1450 g) were studied during the first 28 days of life. The infants were classified as group A (n = 19 infants who never required ventilator support), group B (n = 20 infants mechanically ventilated for minor respiratory problems), and group C (n = 21 infants ventilated for respiratory distress syndrome). Diagnostic blood sampling was measured, infants were checked for clinical symptoms and laboratory signs of anaemia 24 h before and after the transfusion of packed red cells. A total of 7998 punctures (average: 4.8 per infant per day) were performed, the mean blood loss due to diagnostic sampling was 50.3 ml/kg per 28 days (range 7-142) for all infants. A high correlation (rs = +0.91) was found between the blood volumes sampled and transfused. In group A, the mean blood loss was 24 ml/kg, and a total of 29 blood transfusions were administered. The most frequent symptoms of anaemia were poor weight gain and apnoeic spells. In group B, the mean blood loss was 60 ml/kg and a total of 97 blood transfusions were administered. In group C, the mean blood loss was 67 ml/kg and a total of 116 blood transfusions were administered. In both groups B and C, poor weight gain, pallor and distended abdomen were the most frequent symptoms of anaemia. Following the blood transfusion, haematocrit rose and blood pressure remained unchanged. The symptoms that responded most favourably to the blood transfusion were: poor weight gain, oxygen requirement, and distended abdomen. The results emphasize the need for miniaturizing laboratory techniques and monitoring blood sampling.

A Review of Cord Blood Concentrations of Iron Status Parameters to Define Reference Ranges for Preterm Infants

“…Every milliliter of blood loss represents a loss of 0.35-0.5 mg iron (assuming an Hb concentration of 10-15 g/dl). In very low-birthweight infants, iron losses due to phlebotomy can amount up to 6 mg/kg/week [75]. Therefore, it is desirable to search for a method to measure iron status without causing additional blood loss.…”

Collection and 28-Day Storage of Human Placental Blood

“…These transfusions are given to replace losses due to diagnostic sampling and to treat the physiologic decline in H b concentration designated the anemia of prematurity (1)(2)(3). Studies have shown that VLBW infants will receive approximately 50 mL of blood per kg from as many as eight to 10 adult donors during the first month of life (1,3,4). However, recent data suggest that changes in transfusion practices for neonates may reduce donor exposure (5,6).…”

Autologous Placental Blood Transfusion for the Therapy of Anaemic Neonates

“…The aetiology is multifactorial and includes especially iatrogenic blood losses due to laboratory examinations [1][2][3], a lack of erythropoietin [2,[4][5][6], and a lack of nutritive factors [7,8]. However, the reduction of iatrogenic blood losses [9,10], prophylactic iron substitution [11], the use of recombinant human erythropoietin, and placentofetal blood transfusion after delayed cord clamping have reduced but not dispensed with the need for transfusions during the first weeks of life [12,13].…”