Metabolic consequences in very low birth weight infants transfused with older AS-1-preserved erythrocytes

Our study evaluated the biochemical and physiologic changes in extremely pr emature infants receiving AS-1-preserved packed red blood cells (PRBC) stor ed 5 to 21 days, including increase in hemoglobin, maintenance of euglycemi a, and normal serum potassium levels, acid-base balance, and urine output. Twelve infants (birth weight 775 +/- 127 g) with gestational age of 25 +/- 1 weeks received small volume replacement transfusions with 17 mL/kg PRBC p reserved in an AS-1 dedicated unit. Infants were monitored throughout the t ransfusions and blood samples were obtained pre- and postransfusion for com parison by Student's t-test. The infants remained clinically stable through out the transfusions and had an increase in hemoglobin of 2.5 g/dL. There w as no change in urine output. Serum ammonia lactate dehydrogenase (LDH), an d glucose levels were altered as predicted. There were also small, but clin ically insignificant, changes in serum potassium, bicarbonate, total biliru bin, and creatinine. Euglycemia was maintained in 84% of the transfusions. We concluded that small volume transfusions with PRBC stored up to 21 days in AS-1 can be used in the very low birth weight infant without apparent de triment when extensive metabolic criteria are examined.