Effects of increased red cell mass on subclinical tissue acidosis in hyaline membrane disease

AIM: To determine whether there are subclinical deficits in oxygen delivery in ventilated premature neonates. METHOD: Ventilated premature neonates weighing less than 1500 g, who were transfused for anaemia or who were given colloids for clotting abnormalities (or oedema), were haemodynamically moni...

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Bibliographic Details
Published in:Archives of disease in childhood. Fetal and neonatal edition 1996-09, Vol.75 (2), p.F87-F93
Main Authors: La Gamma, E F, Krauss, A, Auld, P A
Format: Article
Language:English
Subjects:
Acidosis - etiology
Acidosis - therapy
Colloids
Erythrocyte Transfusion
Erythrocytes
Humans
Hyaline Membrane Disease - complications
Hyaline Membrane Disease - physiopathology
Hydrogen-Ion Concentration
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight - physiology
Leg - blood supply
Neonates
Oxygen
Oxygen Consumption
Regional Blood Flow
Respiration, Artificial
Ventilation
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Summary:AIM: To determine whether there are subclinical deficits in oxygen delivery in ventilated premature neonates. METHOD: Ventilated premature neonates weighing less than 1500 g, who were transfused for anaemia or who were given colloids for clotting abnormalities (or oedema), were haemodynamically monitored during the first week of life. Calf muscle surface pH (pH) was measured in conjunction with peripheral limb blood flow by occlusion plethysmography. RESULTS: Packed red blood cell transfusions corrected a subclinical regional tissue acidosis (low tpH) without affecting arterial pH or limb blood flow. This observation also correlated with an increase in regional oxygen delivery. The data were also suggestive of a pattern of pathological, supply dependent, oxygen delivery and are similar to other observations made in adults with adult respiratory distress syndrome. CONCLUSIONS: Packed red blood cells increase regional oxygen delivery and tissue surface pH. In contrast, colloid infusion provided no substantial cardiovascular or metabolic benefit to these patients and should be avoided when oxygen delivery is at issue and when there may be leaky pulmonary capillaries.
ISSN:1359-2998
1468-2052
DOI:10.1136/fn.75.2.F87