Metabolic Consequences in very Low Birth Weight Infants Transfused with Older As-1-Preserved Erythrocytes

Abstract

Our study evaluated the biochemical and physiologic changes in extremely premature infants receiving AS-1-preserved packed red blood cells (PRBC) stored 5 to 21 days, including increase in hemoglobin, maintenance of euglycemia, and normal serum potassium levels, acid-base balance, and urine output. Twelve infants (birth weight 775 ± 127g) with gestational age of 25 ± 1 weeks received small volume replacement transfusions with 17 mL/kg PRBC preserved in an AS-1 dedicated unit. Infants were monitored throughout the transfusions and blood samples were obtained pre- and postransfusion for comparison by Student's t-test. The infants remained clinically stable throughout the transfusions and had an increase in hemoglobin of 2.5 g/dL. There was no change in urine output. Serum ammonia lactate dehydrogenase (LDH), and glucose levels were altered as predicted. There were also small, but clinically insignificant, changes in serum potassium, bicarbonate, total bilirubin, 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 detriment when extensive metabolic criteria are examined.

Key Words:

• additive solution 1 (AS-1)
• dedicated unit
• packed red blood cells (PRBC)
• transfusion
• very low birth weight (VLBW)