THE EFFECT OF BLOOD-TRANSFUSION ON OXYGENATION IN PREMATURE VENTILATED NEONATES

The effect of blood transfusion to maintain a preset packed cell volum e (PCV) level in preterm ventilated infants has been investigated. Fif ty infants, median gestational age 26 (range 23-33) weeks and postnata l age 4 (1-29) days, transfused a median of 15 ml/kg of blood in respo nse to a PCV less than or equal to 40% were retrospectively identified and their medical records reviewed to determine the change in PCV and haemoglobin resulting from the transfusions. In addition, their mean airway pressure (MAP) was noted and, as an index of oxygenation, their oxygenation index (OI), alveolar/arterial oxygen gradient (AaDO(2)) a nd arterial/alveolar (a/A) ratio calculated 12 h, 6 h and immediately prior to the transfusion and immediately post, 12, 18 and 24 h after t he transfusion. The transfusion improved the PCV and haemoglobin (P < 0.0001). No significant changes in MAP or level of oxygenation were ex perienced in the 12 h prior to the transfusion. Post transfusion, desp ite no significant change in MAP, the AaDO(2) OI and a/A ratios compar ed to immediately prior to the transfusion were significantly better a t 12, 18 and 24 h. Conclusion It is useful to transfuse ventilated pre term infants to maintain their PCV above a preset level.