Effect of transfusion on the venous blood lactate level in very low‐birthweight infants

Takahashi, Daijiro; Matsui, M; Shigematsu, Reiko; Sato, Toshio; Miyaji, Ryosuke; Sakai, Michio; Shirahata, Akira

doi:10.1111/j.1442-200x.2008.02733.x

Cited by 11 publications

(5 citation statements)

References 21 publications

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“…Serum lactate is an end product of strained anaerobic cellular metabolism and is elevated in tissue hypoxia, hypoperfusion, or injury. Serum lactate has been tested by few researchers as a marker of tissue perfusion and its usefulness as a biochemical trigger for transfusion in newborn infants32‐35 (Table ).…”

Section: Established Methods To Assess the Need For Blood Transfusionmentioning

confidence: 99%

“…It has been demonstrated that pretransfusion serum lactate level decreases significantly after RBC transfusion 34‐36. In a randomized study of 16 preterm infants Ross and colleagues demonstrated that blood lactate may be useful to identify preterm infants who will benefit from RBC transfusion.…”

Section: Established Methods To Assess the Need For Blood Transfusionmentioning

confidence: 99%

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Biomarkers to decide red blood cell transfusion in newborn infants

Banerjee

Aladangady

2014

Transfusion

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Almost 90% of extremely low birthweight infants receive red blood cell (RBC) transfusion during their stay in the neonatal unit (NNU). Currently most NNUs use a combination of clinical signs and laboratory findings such as hemoglobin (Hb), hematocrit (Hct), and cardiorespiratory or ventilation status to decide the need for RBC transfusion. Various other laboratory (lactate, reticulocyte count, RBC volume) and bedside measurements (near infrared spectroscopy and Doppler ultrasound scan) have been investigated to identify a suitable trigger for RBC transfusion in newborn infants. The evidence to apply any of these investigations or measurements to clinical practice is lacking. Further research is required to identify a suitable biomarker for RBC transfusion in newborn infants.

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Section: Established Methods To Assess the Need For Blood Transfusionmentioning

confidence: 99%

Section: Established Methods To Assess the Need For Blood Transfusionmentioning

confidence: 99%

Biomarkers to decide red blood cell transfusion in newborn infants

Banerjee

Aladangady

2014

Transfusion

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“…The cut-off value for blood lactate (>1.8 mmol/L) was based on the reference range from the local laboratory. Lactate was used in the past as a marker of an oxygen deficit, helping in the optimal timing of RBC transfusion [ 20 ]. Lactate was used as a physiologic transfusion trigger due to limited number of patients in whom ScvO 2 could be determined.…”

Section: Methodsmentioning

confidence: 99%

Appropriateness of Allogeneic Red Blood Cell Transfusions in Non-Bleeding Patients in a Large Teaching Hospital: A Retrospective Study

Czempik

Wilczek

Herzyk

et al. 2023

JCM

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In hemodynamically stable patients, both anemia and red blood cell (RBC) transfusion may be detrimental to patients; hence, a decision regarding RBC transfusion should be based on thorough risk–benefit assessment. According to hematology and transfusion medicine organizations, RBC transfusion is indicated when recommended hemoglobin (Hb) triggers are met, and symptoms of anemia are present. The aim of our study was to examine the appropriateness of RBC transfusions in non-bleeding patients at our institution. We performed a retrospective analysis of all RBC transfusions performed between January 2022 and July 2022. The appropriateness of RBC transfusion was based on the most recent Association for the Advancement of Blood and Biotherapies (AABB) guidelines and some additional criteria. The overall incidence of RBC transfusions at our institution was 10.2 per 1000 patient-days. There were 216 (26.1%) RBC units appropriately transfused and 612 (73.9%) RBC units that were transfused with no clear indications. The incidence of appropriate and inappropriate RBC transfusions were 2.6 and 7.5 per 1000 patient-days, respectively. The most frequent clinical situations when RBC transfusion was classified as appropriate were: Hb < 70 g/L plus cognitive problems/headache/dizziness (10.1%), Hb < 60 g/L (5.4%), and Hb < 70 g/L plus dyspnea despite oxygen therapy (4.3%). The most frequent causes of inappropriate RBC transfusions were: no Hb determination pre-RBC transfusion (n = 317) and, among these, RBC transfused as a second unit in a single-transfusion episode (n = 260); absence of anemia sings/symptoms pre-transfusion (n = 179); and Hb concentration ≥80 g/L (n = 80). Although the incidence of RBC transfusions in non-bleeding inpatients in our study was generally low, the majority of RBC transfusions were performed outside recommended indications. Red blood cell transfusions were evaluated as inappropriate mainly due to multiple-unit transfusion episodes, absence of anemia signs and/or symptoms pre- transfusion, and liberal transfusion triggers. There is still the need to educate physicians on appropriate indications for RBC transfusion in non-bleeding patients.

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“…Одним из них является метод определения тканевой оксигенации с помощью NIRS. Данный метод позволяет оценить различия между показателями церебральной и периферической оксигенации [17,25]. В ряде исследований описано улучшение показателей тканевой оксигенации, определенных с помощью NIRS, после заместительной трансфузии ЭСК крови у недоношенных новорожденных [8,9,24,26].…”

Section: обсуждение результатов исследованияunclassified

Application of near-infrared spectroscopy in extremely and very low birth weight infants for red blood cells transfusion

Шарафутдинова¹,

Balashova²,

Ionov³

et al. 2020

Voprosy gematologii/onkologii i immunopatologii v pediatrii

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Near-infrared spectroscopy (NIRS), or cerebral oximetry, is a non-invasive method for assessing the oxidative status (saturation of hemoglobin with oxygen) mainly in the blood of cerebral venous vessels, which is increasingly used in clinical practice, in particular in neonatology. This method allows us to evaluate not only tissue perfusion, but also to determine the differences between the indicators of cerebral and peripheral oxygenation. Few studies have described improvements in tissue oxygenation indicators determined by NIRS after red blood cells transfusion in premature newborns. In our study we registered the oximetry indicators before and after red blood cells transfusion in extremely and very low birth weight infants (n = 55). This clinical study was approved by the Biomedical Research Ethics Committee (Protocol No. 19 dated 17 November 2016) and the Scientific Council of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of the Russian Federation (Protocol No. 19 dated 29 November 2016). Our study demonstrated a statistically significant increase in CrSO2 , SrSO2 , RrSO2 and SCOR and a decrease in C-FTOE, S-FTOE after a blood transfusion. The study also showed that a decrease in NIRS values (SCOR ≤ 0.76, C-FTOE ≥ 0.29, CrSO2 ≤ 64%, SrSO2 ≤ 54%, and RrSO2 ≤ 56%) can serve as an additional non-invasive measure of anemia and its progression; it helps detect a decrease in cerebral oxygenation at an early, preclinical stage of disease, and can also be used as an additional indicator of the need for red blood cell transfusions.

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Effect of transfusion on the venous blood lactate level in very low‐birthweight infants

Cited by 11 publications

References 21 publications

Biomarkers to decide red blood cell transfusion in newborn infants

Biomarkers to decide red blood cell transfusion in newborn infants

Appropriateness of Allogeneic Red Blood Cell Transfusions in Non-Bleeding Patients in a Large Teaching Hospital: A Retrospective Study

Application of near-infrared spectroscopy in extremely and very low birth weight infants for red blood cells transfusion

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