Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Grant, Monica J.; Huether, Sue E.; Witte, Madolin K.

doi:10.1097/01.pcc.0000090291.39953.39

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…Clinical studies attempting to determine the effect of RBC transfusions on O 2 kinetics have not provided definitive answers. We identified 19 clinical studies [75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93] evaluating the impact of RBC transfusions on O 2 kinetics in humans. All studies measured DO 2 and O 2 consumption before and after the transfusion of a specified number of allogeneic RBCs.…”

Section: Clinical Studies Of O 2 Kineticsmentioning

confidence: 99%

Clinical consequences of red cell storage in the critically ill

et al. 2006

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Red cell (RBC) transfusions are a potentially life-saving therapy employed during the care of many critically ill patients to replace losses in hemoglobin to maintain oxygen delivery to vital organs. During storage, RBCs undergo a series of biochemical and biomechanical changes that reduce their survival and function. Additionally, accumulation of other biologic by-products of RBC preservation may be detrimental to recipients of blood transfusions. Laboratory studies and an increasing number of observational studies have raised the possibility that prolonged RBC storage adversely affects clinical outcomes. In this article, the laboratory and animal experiments evaluating changes to RBCs during prolonged storage are reviewed. Subsequently, the clinical studies that have evaluated the clinical consequences of prolonged RBC storage are reviewed. These data suggest a possible detrimental clinical effect associated with the transfusion of stored RBCs; randomized clinical trials further evaluating the clinical consequences of transfusing older stored RBCs are required.

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Section: Clinical Studies Of O 2 Kineticsmentioning

confidence: 99%

Clinical consequences of red cell storage in the critically ill

et al. 2006

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“…Increases in ABP occur following transfusion of NLR-pRBCs in adult humans (Shoemaker and Wo, 1998; Saugel et al, 2013) and after transfusion of LR-pRBCs in premature and low birth-weight infants (Rankova and Beshinska, 1989; Bauer et al, 1993; Alkalay et al, 2003) and neonates (Rashid et al, 2013) but not always in children with severe anemia (Grant et al, 2003; Olgun et al, 2009). Transfusions of LR-pRBCs do not always impact ABP because of lower pRBC volumes and transfusion rates (Nelle et al, 1994, 1997) and because increases in total peripheral resistance are matched by decreases in cardiac output (CO) (Nelle et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

Effects of non-leukocyte-reduced and leukocyte-reduced packed red blood cell transfusions on oxygenation of rat spinotrapezius muscle

Sundararajan

Dodhy

Pittman

et al. 2014

Microvascular Research

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Leukoreduction of blood used for transfusion alleviates febrile transfusion reactions, graft versus host disease and alloimmunization to leukocyte antigen. However, the actual clinical benefit of leukoreduction in terms of microcirculatory tissue O2 delivery after packed red blood cell (pRBC) transfusion has not been investigated. As such, the aim of this study was to determine the effects of non-leukoreduced (NLR) and leukoreduced (LR) fresh pRBC transfusion on interstitial oxygenation in anesthetized male Sprague-Dawley rats. Interstitial fluid PO2 and arteriolar diameters in spinotrapezius muscle preparations were monitored before and after transfusion with NLR- or LR-pRBCs. The major findings were that (1) transfusion of NLR-pRBCs significantly decreased interstitial oxygenation whereas transfusion of LR-pRBCs did not, and (2) transfusion with LR-pRBCs elicited a substantially greater increase in arterial blood pressure (ABP) than did transfusion with NLR-pRBCs. These changes in PO2 and ABP were not associated with changes in the diameters of resistance arterioles in the spinotrapezius muscle. These data suggest that transfusion of fresh NLR-pRBCs may negatively affect tissue oxygenation via enhanced leukocyte influx and decreased O2 delivery. They also suggest that leukocytes diminish the capability of transfused pRBCs to increase cardiac output. As such, transfusion of LR-pRBCs may be less deleterious on tissue PO2 levels than NLR-pRBCs although a concomitantly greater increase in ABP may accompany transfusion of LR-pRBCs.

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“…Children generally have structurally intact cardiopulmonary systems allowing for compensation of severe anemia (ie, Hb ,7.0 g/dL) with chronic onset, and can adapt without significant symptoms to an oxygen deficient state. 6 The acute symptoms of anemia unique to young patients include poor feeding, irritability, and lethargy, while older children may complain of loss of appetite, fatigue, headache, dizziness, and loss of concentration, and families may note a change in behavior and school performance. Signs of anemia are often related to severity and rapidity of onset and may include pallor, tachycardia, prominent arterial pulses, tachypnea, postural hypotension, cardiac murmurs, gallop rhythm, cardiac enlargement on chest X-ray, and evidence of congestive heart failure, presenting as hepatomegaly and periorbital edema rather than peripheral edema and increased jugular venous distension as in adults.…”

Section: Age-dependent Signs and Symptoms Of Anemiamentioning

confidence: 99%

Unique aspects of red blood cell transfusion in pediatric patients

Rai¹,

Kelly²,

Agrawal³

2016

IJCTM

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Red blood cell transfusion plays an integral role in the management of the anemic child, and multiple factors must be considered when performing transfusions in children as compared with adults. The practitioner must be aware of the particular indication for transfusion, normal hemoglobin for age, and the need for special requirements based on the age and type of patient. Additionally, the practitioner must be aware of potential unique complications in the pediatric population and also ensure a system is in place in order to report and evaluate such potential adverse reactions. Here, we review the underlying physiological factors, symptomatology, transfusion guidelines, transfusion reactions, and potential side effects with an emphasis on those aspects that are unique to children with anemia. Many gaps remain in fully understanding pediatric red blood cell transfusion that should be addressed over time with continued research and hemovigilance.

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Effect of red blood cell transfusion on oxygen consumption in the anemic pediatric patient

Cited by 11 publications

References 31 publications

Clinical consequences of red cell storage in the critically ill

Clinical consequences of red cell storage in the critically ill

Effects of non-leukocyte-reduced and leukocyte-reduced packed red blood cell transfusions on oxygenation of rat spinotrapezius muscle

Unique aspects of red blood cell transfusion in pediatric patients

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