Comparison of Hemoglobin Correction Effects According to Storage Period and Other Factors in the Transfusion of Packed Red Blood Cells in Neonatal Intensive Care Unit Patients
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Purpose: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. Methods: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (≤7 days, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. Results: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. Conclusion: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.
Abstract
Purpose: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. Methods: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (≤7 days, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. Results: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. Conclusion: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.
참고문헌 (26)
- Quinn K, "Neonatal transfusion models to determine the impact of using fresh red blood cells on inventory and exposure", Blood Transfus, 13, pp.595~599 (2015)
- Lee SH, "The use of quadruple blood bags transfusion of low birth weight neonates", J Korean Pediatr Soc, 42, pp.1122~1129 (1999)
- Bell EF, "Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants", Pediatrics, 115, pp.1685~1691 (2005)
- Kim HM, "Advances in neonatal care and outcome of low birth weight infants", J Korean Pediatr Soc, 39, pp.762~772 (1996)
- 김성신, "미숙아에서 최적의 혈색소", Neonatal medicine, 21(2), pp.92~98 (2014), 대한신생아학회
- Fernandes da Cunha DH, "Transfusions of CPDA-1 red blood cells stored for up to 28 days decrease donor exposures in very low-birth-weight premature infants", Transfus Med, 15, pp.467~473 (2005)
- Kasat K, "Neonatal red blood cell transfusions: searching for better guidelines", Blood Transfus, 9, pp.86~94 (2011)
- Whyte RK, "Red blood cell transfusion in newborn infants", Paediatr Child Health, 19, pp.213~222 (2014)
- Tinmouth A, "Clinical consequences of red cell storage in the critically ill", Transfusion, 46, pp.2014~2027 (2006)
- Hogman CF, "Storage parameters affecting red blood cell survival and function after transfusion", Transfus Med Rev, 13, pp.275~296 (1999)
- Hess JR, "Red cell storage", J Proteomics, 73, pp.368~373 (2010)
- Lion N, "Stored red blood cells: a changing universe waiting for its map(s)", J Proteomics, 73, pp.374~385 (2010)
- Mangel J, "Reduction of donor exposures in premature infants by the use of designated adenine- saline preserved split red blood cell packs", J Perinatol, 21, pp.363~367 (2001)
- Fergusson DA, "Effect of fresh red blood cell transfusions on clinical outcomes in premature, very low-birth-weight infants: the ARIPI randomized trial", JAMA, 308, pp.1443~1451 (2012)
- Lee DA, "Reducing blood donor exposures in low birth weight infants by the use of older, unwashed packed red blood cells", J Pediatr, 126, pp.280~286 (1995)
- "Blood Information Sharing System" (2018)[URL]
- The Korean Society of Neonatology, "Indications of transfusion in manual of neonatal care" (2014), Korean Society of Neonatology
- Nortfolk D, "Handbook for transfusion medicine" (2013), Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee
- Shanmugha Priya RA, "Transfusion support in preterm neonates <1500 g and", or <32 weeks in a tertiary care center: a descriptive study, 2018, pp.12, 34~41
- Fasano RM, "Fanaroff and Martin’s neonatal-perinatal medicine", pp.1344~1361 (2015), Elsevier
- New York State Department of Health, "Guidelines for transfusion therapy of infants from birth to four months of age" (2004), New York State Council on Human Blood and Transfusion services
- Said Conti V, "Overview of the blood transfusion policy in preterms on the neonatal intensive care unit", Malta Med J, 25, pp.46~50 (2013)
- 전가원, "Risk Factors of Transfusion in Anemia of Very Low Birth Weight Infants", Yonsei Medical Journal, 54(2), pp.366~373 (2013), 연세대학교의과대학[DOI]
- Alan S, "Prevention of the anaemia of prematurity", Int J Pediatr Adolesc Med, 2, pp.99~106 (2015)
- Freitas BA, "Factors associated with packed red blood cell transfusions in premature infants in an intensive care unit", Rev Bras Ter Intensiva, 24, pp.224~229 (2012)
- Liu EA, "Prospective, randomized trial of the safety and efficacy of a limited donor exposure transfusion program for premature neonates", J Pediatr, 125, pp.92~96 (1994)