Neonatal Med.  2018 Nov;25(4):170-177. 10.5385/nm.2018.25.4.170.

Comparison of Hemoglobin Correction Effects According to Storage Period and Other Factors in the Transfusion of Packed Red Blood Cells in Neonatal Intensive Care Unit Patients

• Park JH
• Kong SG
• Hong YR

• KMID: 2436135
• DOI: http://doi.org/10.5385/nm.2018.25.4.170

Abstract

PURPOSE
Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction.
METHODS
This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (≤7 days, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction.
RESULTS
Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb.
CONCLUSION
The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.

Keyword

Premature birth; Erythrocyte aging; Erythrocyte transfusion; Newborn infant; Hemoglobins

MeSH Terms

Birth Weight
Blood Cell Count
Erythrocyte Aging
Erythrocyte Transfusion
Erythrocytes*
Hematologic Tests
Humans
Infant
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Intensive Care, Neonatal*
Medical Records
Premature Birth
Retrospective Studies
Ventilators, Mechanical

Figure

• 

  Figure 1. Duration of red blood cell (RBC) storage by study group. The mean storage period of red blood cells was 10.01±5.13 days, ranging from 1 day to a maximum of 32 days. The means of the short-term and long-term storage groups were 4.69±1.75 and 12.45 ±4.25 days, respectively.

• 

  Figure 2. Comparison of differences in hemoglobin levels between the short-term and long-term storage groups. There was no significant difference between changes in hemoglobin levels before and after transfusion. It was 1.25±2.20 g/dL in the shortterm storage group and 1.49±1.83 g/dL in the long-term storage group (P=0.537).

• 

  Figure 3. Red blood cell storage duration versus the difference in hemoglobin levels in the total study group. There was no statistically significant correlation between the number of days of storage of red blood cells and the change in hemoglobin levels before and after blood transfusion (P=0.152).

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