Transfusion Volume in Infants With Very Low Birth Weight: A Randomized Trial of 10 Versus 20 mL/kg

Paul, David A.; Leef, Kathleen H; Locke, Robert; Stefano, John L.

doi:10.1097/00043426-200201000-00012

Cited by 39 publications

(28 citation statements)

References 16 publications

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“…This amount agrees with actual studies about the administration of red blood cells. In doing so transfusion of 20 ml/kg produces no detrimental effects on pulmonary function [36] . Assuming an IGF-1-concentration of about 12 g/l in RBC, a transfusion volume of 15 ml/kg is equivalent to an application of 0.054 g IGF-1 for every kg bodyweight [(plasma !…”

Section: Discussionmentioning

confidence: 93%

Does Insulin-Like Growth Factor 1 Contribute in Red Blood Cell Transfusions to the Pathogenesis of Retinopathy of Prematurity during Retinal Neovascularization?

Hübler

Knote²,

Kauf³

et al. 2006

Neonatology

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Background: Red blood cell (RBC) transfusions are associated with the development of retinopathy of prematurity (ROP). During the period of retinal neovascularization a rise of insulin-like growth factor 1 (IGF-1) may trigger rapid growth of new blood vessels. Objectives: To study endocrine factors in RBC transfusions that might be of importance for ROP. Methods: IGF-1, IGF-2 and their binding proteins 1–3 (IGFBP-1–3) were determined by radioimmunoassays in 7 very-low-birthweight (VLBW) infants with ROP ≧ stage 2 receiving a RBC transfusion, in 10 controls (VLBW infants with ROP ≤ stage 1, no transfusion), in supernatants of 7 RBCs and of 5 washed RBCs (WRBC). Results: IGF-1 (mean ± SD) in infants with ROP was 20.0 ± 4.2 µg/l, in controls 35.9 ± 15.2 µg/l (Mann-Whitney U test, p = 0.030). IGF-1 in RBC was 12.88 ± 5.03 µg/l and in WRBC 0.45 ± 0.74 µg/l (average of the three-course washing procedure). IGF-2 in infants with ROP was 485.67 ± 158.73 µg/l, in controls 389.9 ± 102.8 µg/l (not significant), in RBC 109.50 ± 117.89 µg/l, in WRBC 61.07 ± 30.0 µg/l. Except for IGFBP-3 other IGFBPs were barely or not detectable in RBC or WRBC. Conclusions: Considering lower IGF-1 concentrations in preterm infants than in adults (factor 20), the IGF-1 in RBC transfusions is equivalent to a single dose of 1 µg/kg IGF-1 (5–10% of the adult dose with proved metabolic responses). Endocrinological relationships between the donor’s load and the acceptor’s individual features are a new aspect of potential side effects of RBC transfusions. Further research is necessary to clarify the share of the described IGF administration on the development of ROP.

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Section: Discussionmentioning

confidence: 93%

Does Insulin-Like Growth Factor 1 Contribute in Red Blood Cell Transfusions to the Pathogenesis of Retinopathy of Prematurity during Retinal Neovascularization?

Hübler

Knote²,

Kauf³

et al. 2006

Neonatology

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“…8 All svPRBCs were 20 cm 3 /kg and given over a period of 2 to 4 hours. 9 The determination of whether an infant needed a transfusion was based upon clinical reasons independent of this study protocol and usually within the suggested parameters. 7 Infant cytokine analysis occurred by obtaining 0.8 cm 3 of serum (1.6 cm 3 of whole blood) within 6 hours prior to the transfusion and 1-hour post completion of transfusion.…”

Section: Methodsmentioning

confidence: 99%

Cytokine Load in Prestorage Leukoreduced PRBC Transfusions in Premature Infants

et al. 2005

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“…Frequency of blood transfusion in the low-birth-weight infants varies from 5 to as much as 10 per infant [2]. Blood transfusion practices seem to vary from one hospital to another and from one practitioner to another [1,3]. Volumes of blood required for transfusion are still issues of debate [3].…”

mentioning

confidence: 99%

“…Blood transfusion practices seem to vary from one hospital to another and from one practitioner to another [1,3]. Volumes of blood required for transfusion are still issues of debate [3]. Sometimes decisions to transfuse are based not on sound clinical judgment but on supposed needs.…”

mentioning

confidence: 99%

Which Babies Get Blood in Jos-Nigeria?

Pam

Bode-Thomas

Joseph

et al. 2004

Pediatric Hematology and Oncology

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Documentation of the transfusion needs of neonatal units is required to guide blood banks in meeting demands. A prospective observational study of newborn transfusions over 35 weeks was conducted. Eighty-four transfusions were conducted in 62 of 377 (16.45%) admitted infants in 35 weeks. Neonatal jaundice (57.2%) and anemia (38.1%) were main indications. In 85.7% cases, blood transfused was < 3 days old. Weight of infants at transfusion was < 2500 g in 51.6% cases. Infants were first transfused at < 7 days in 59.7% cases. Whole blood was used in 64.3% of all cases. Overall transfusion rate was 2.4/week. Neonatal jaundice is the commonest indication for transfusion and whole blood is in greater demand.

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Transfusion Volume in Infants With Very Low Birth Weight: A Randomized Trial of 10 Versus 20 mL/kg

Abstract: Transfusion with 20 mL/kg red blood cells produces a significantly greater increase in hemoglobin and hematocrit levels than does a transfusion with 10 mL/kg, without any detrimental effects on pulmonary function.

Cited by 39 publications

References 16 publications

Does Insulin-Like Growth Factor 1 Contribute in Red Blood Cell Transfusions to the Pathogenesis of Retinopathy of Prematurity during Retinal Neovascularization?

Does Insulin-Like Growth Factor 1 Contribute in Red Blood Cell Transfusions to the Pathogenesis of Retinopathy of Prematurity during Retinal Neovascularization?

Cytokine Load in Prestorage Leukoreduced PRBC Transfusions in Premature Infants

Which Babies Get Blood in Jos-Nigeria?

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