Haemodynamic effects of differing blood transfusion rates in infants less than 1500 g

Objective : To investigate whether the haemodynamic effects of the standard 2-3 h blood transfusion increases the risk for intraventricular haemorrhage (IVH) and patent ductus arteriosus (PDA) in very low birthweight infants.
Methodology : In a randomized controlled study, haemodynamic changes using slow and rapid transfusion were compared. Twenty-seven very low birthweight infants were divided between 12 h ( n = 14) and 3 h ( n = 13) transfusion groups. Blood pressure, ejection fraction (EF), anterior cerebral artery pulsatility index (Pl), blood gases, serum electrolytes and haematocrit were measured pre- and post-transfusion. Infectious status was also monitored.
Results : Blood pressure (48.1/25.5 vs 55.7/30.2 mmHg) and EF (0.68 vs 0.73) increased significantly during rapid transfusion ( P >0.01) but remained stable with slow transfusion. Serum potassium, base excess and incidence of infection did not increase in either group.
Conclusions : Slow transfusion causes less haemodynamic disturbance than rapid transfusion, thereby preventing the potential risk for IVH and PDA.