The Age of Red Blood Cells in Premature Infants (ARIPI) Randomized Controlled Trial: Study Design

Fergusson, Dean; Hutton, Brian; Hogan, Debora; LeBel, Louise; Blajchman, Morris A.; Ford, Jason C.; Hébert, Paul C.; Kakadekar, Ashok; Kovács, Lajos; Lee, Shoo; Sankaran, Koravangattu; Shapiro, Stan; Smyth, John; Ramesh, Kuppuchipalayam; Bouali, Nicole Rouvinez; Tinmouth, Alan; Walker, Robin

doi:10.1016/j.tmrv.2008.09.005

Cited by 64 publications

(54 citation statements)

References 37 publications

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“…The present study also does not provide insights into the effects of storage age of RBCs as we exclusively use RBC units that are ≤14 days old. Although we did detect a 1-day difference in the mean storage age of RBCs received by NEC/RBC-transfused patients vs. the non-NEC/RBC-transfused controls, the clinical importance of this small difference is unclear (30). We also do not have detailed information on potential confounders such as feeding practices, human milk intake, and antibiotic use.…”

Section: Discussionmentioning

confidence: 71%

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Josephson¹,

Wesolowski²,

Bao³

et al. 2010

The Journal of Pediatrics

116

100

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BACKGROUND Recent studies have detected an association between red blood cell (RBC) transfusions and NEC. We hypothesized that RBC transfusions increase the risk of NEC in premature infants, and investigated whether the risk of ‘transfusion-associated’ NEC is higher in infants with lower hematocrits and advanced postnatal age. METHODS Retrospective comparison of NEC patients and controls born at <34 weeks gestation. RESULTS The frequency of RBC transfusions was similar in NEC patients (47/93, 51%) and controls (52/91, 58%). Late-onset NEC (> 4 weeks of age) was more frequently associated with a history of transfusion(s) than early-onset NEC (adjusted OR=6.7; 95% CI=1.5–31.2; p=0.02). Compared to non-transfused patients, RBC-transfused patients were born at an earlier gestational age, had greater intensive care needs (including at the time of onset of NEC), and longer hospital stay. A history of RBC transfusions within 48-hours prior to NEC onset was noted in 38% of patients, most of whom were extremely low birth weight (ELBW) infants. CONCLUSIONS In most patients, RBC transfusions were temporally unrelated to NEC and may be merely a marker of overall severity of illness. However, the relationship between RBC transfusions and NEC requires further evaluation in ELBW infants using a prospective cohort design.

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Section: Discussionmentioning

confidence: 71%

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Josephson¹,

Wesolowski²,

Bao³

et al. 2010

The Journal of Pediatrics

116

100

View full text Add to dashboard Cite

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“…19 The study was approved by the research ethics boards both at the central coordinating center and at each of the participating sites.…”

Section: Methodsmentioning

confidence: 99%

Effect of Fresh Red Blood Cell Transfusions on Clinical Outcomes in Premature, Very Low-Birth-Weight Infants

Fergusson¹,

Hébert²,

Hogan³

et al. 2012

JAMA

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393

306

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“…9,21–23 As the stored RBCs age, they undergo biochemical and biophysical changes that are often collectively referred to as the storage lesion, 24–30 which has been a subject of significant number of recent clinical studies, including three large, randomized controlled trials that did not show any adverse clinical effects of transfusing longer stored RBCs in a variety of patient populations. 31–33 Using this change in the RBCs’ magnetic properties between the oxygenated, deoxygenated, and met form of Hb, Jin et al . reported that the magnetic susceptibility of RBCs changes during ex vivo storage, and they suggested this change in magnetic susceptibility is a result in changes in the affinity of Hb for O 2 or loss of Fe/Hb from the RBCs.…”

Section: Introductionmentioning

confidence: 99%

Femtogram Resolution of Iron Content on a Per Cell Basis: Ex Vivo Storage of Human Red Blood Cells Leads to Loss of Hemoglobin

et al. 2017

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The magnetic characteristics of hemoglobin (Hb) changes with the binding of dioxygen (O2) to the heme prosthetic groups of the globin chains: from paramagnetic ferrous Hb to diamagnetic ferrous oxyhemoglobin (oxyHb) with reversibly bound O2, or paramagnetic ferric methemoglobin (metHb). When multiplied over the number of Hb molecules in a red blood cell (RBC), the effect is detectable through motion analysis of RBCs in a high magnetic field and gradient. This motion is referred to as magnetophoretic mobility which can be conveniently expressed as a fraction of the cell sedimentation coefficient. In this report, using a previously developed and reported instrument, cell tracking velocimetry (CTV), we are able to detect difference in Hb concentration in two RBC populations to a resolution of 1 × 107 Hb molecules per cell (4 × 107 atoms of Fe per cell, or 4 – 5 femtograms of Fe). Similar resolution achieved with Inductively Coupled Plasma-Mass Spectrometry requires on the order of 105 – 106 cells and provides an average, whereas CTV provides a measurement for each cell. CTV analysis revealed that RBCs lose, on average, 16% of their Hb after 42 days of storage over the maximum FDA-approved length of time for the cold storage of RBCs in additive solution. This difference in Hb concentration was the result of routine RBC storage; clinical implications are discussed.

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The Age of Red Blood Cells in Premature Infants (ARIPI) Randomized Controlled Trial: Study Design

Cited by 64 publications

References 37 publications

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Effect of Fresh Red Blood Cell Transfusions on Clinical Outcomes in Premature, Very Low-Birth-Weight Infants

Femtogram Resolution of Iron Content on a Per Cell Basis: Ex Vivo Storage of Human Red Blood Cells Leads to Loss of Hemoglobin

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