Exchange Transfusion in the Neonate with ACD or CPD Stored Blood

Abstract

The blood of two groups of five neonates was exchanged to manage a hemolysis due to ABO incompatibility. Exchange transfusions were performed with ACD or CPD blood stored for less than 48 h. Blood oxygen affinity, hemoglobin, and 2,3-diphosphoglycerate concentrations, plasma and erythrolysate pH were measured on blood samples before and several times during the 24 h following the exchange. Infants transfused with CPD blood increased their P50 and 2,3-DPG concentration more rapidly than the group receiving ACD blood. Estimates of oxygen unloading capacities have been calculated, taking into account variations in hemoglobin concentration, P₅₀, and pH. Assuming a constant cardiac output, transfusion with CPD blood might be more valuable than with ACD blood to insure oxygen transport, especially in infants with respiratory or cardiac impairments.

Functional Restoration of ACD‐Blood by Pyridoxal 5′‐Phosphate

“…It is well known that 2,3-DPG-depleted erythrocytes (of stored ACD-blood) synthesize 2,3-DPG in the circulation after transfusion and the oxygen transport function returns to that of the fresh blood (Beutler & Wood, 1969;Bursaux et al, 1973;Dickerman et al, 1973).…”