Anemia and the need for transfusion of packed red blood cells

Anemia and the need for transfusion of packed red blood cells (PRBCs) are common in preterm infants. for BPD was 9.80 (95% confidence interval, 1.70C56.36; P = 0.01). This study demonstrated an association between PRBC transfusion and BPD in preterm infants. A cautious approach to PRBC transfusion in these infants is warranted. Anemia requiring transfusion of packed red blood cells (PRBCs) is relatively common in preterm infants. PRBC transfusion is typically applied based LY294002 ic50 on clinical judgment and evidence-based guidelines that can vary among hospitals, because reliable markers of reduced tissue oxygen delivery have yet to be identified. Both restrictive and liberal guidelines are practiced1,2,3. Most symptoms of reduced tissue oxygen delivery in preterm infants, such as LY294002 ic50 tachycardia, slow weight gain, apnea, and lactic acidosis, are the direct result of chronic anemia in these patients. PRBC transfusion can improve these symptoms and increase the hematocrit (Hct) value4,5,6,7. However, transfusion also may introduce some inflammatory mediators, such as interleukin (IL)-1, IL-8, tumor necrosis factor-, and monocyte chemoattractant protein8,9. Furthermore, the ability of RBCs to deliver oxygen may be diminished by changes in the cell membranes that alter RBC deformability and decrease their ability to scavenge nitric oxide as well as by biochemical changes such as a reduction in 2,3-diphosphoglycerate levels10,11. Together, these factors can lead to higher prices of body organ dysfunction and morbidity such as for example necrotizing enterocolitis (NEC) and bronchopulmonary dysplasia (BPD). Consequently, it’s important for clinicians dealing with preterm infants to comprehend the potential dangers of PRBC transfusion, bPD particularly. In this scholarly study, we hypothesized that suprisingly low delivery pounds (VLBW) or gestational age group (GA) 32 weeks of premature babies who get a PRBC transfusion possess an increased threat of developing BPD. We also assessed if the age group initially PRBC quantity and transfusion of PRBC transfusions impact the occurrence of BPD. Individuals and Strategies Research placing The analysis population comprised live-born neonates with a BW of 500C1,500?g or GA of 22C32 weeks who were admitted to the neonatal intensive care unit of Hangzhou First People’s Hospital from August, 2008 to November, 2013. We excluded infants with major congenital anomalies, those who died before 28 days of life, or those for whom pulmonary outcome data were missing. This study was approved LY294002 ic50 by the ethics committees of Hangzhou First People’s Hospital, and the database of all patients’ data was permitted to use by the ethics committees of Hangzhou First People’s Hospital. Written informed consent was obtained from all their parents when patients were be hospitalized. PRBC transfusions were based upon standard transfusion guidelines described by Roseff et al.12: (1) Hematocrit (Hct) 35% in an infant with a fraction of inspired oxygen (FiO2) 30% who was on continuous positive airway pressure/intermittent mandatory ventilation with mean airway pressure 6?cm H2O; (2) Hct 30% in an infant with an FiO2 30% who was on continuous positive airway pressure and/or intermittent mandatory ventilation with mechanical ventilation with mean airway pressure 6?cm H2O; had significant apnea or bradycardia ( 6 episodes in 12?hr or 2 episodes in 24?hr requiring bag and mask ventilation while receiving therapeutic doses of methylxanthines); had significant tachycardia or tachypnea (heart rate 180?beats/min for 24?hr; respiratory rate 80?breaths/min for 24?hr); and exhibited slow weight gain ( 10?g/day over 4 days while receiving 100?kcal/kg/day). PRBC transfusion included 20?ml/kg PRBCs over 4 to 6 6?hours. Furosemide, 0.5?mg/kg, was given LY294002 ic50 after the transfusion. Patients’ vital signs were recorded every 15?min by the nursing staff. No corticosteroids or vitamin A were used Rabbit Polyclonal to STAT5A/B to prevent BPD. Study design This study was an observational cohort study to assess the impact of PRBC transfusion on BPD as well as other neonatal morbidities in premature infants. The patients were divided into two groups: group 1 who received PRBC transfusions before the diagnosis of BPD or undiagnosed BPD and group 2 who did not received PRBC transfusion or were given PRBC transfusion after diagnosis of BPD. The number of transfusions in group 1 stats up to 36 weeks’ PMA. Data collection Data.