Effects of blood transfusion on left ventricular output in premature babies

Objective:   To investigate the acute effects of red blood cell transfusion on haemodynamics in preterm babies.
Setting:   A neonatal unit in a University Hospital.
Patients:   Preterm babies whose postnatal age was less than four weeks and who required red blood cell transfusion.
Measurement:   Cardiac output and left ventricular systolic function was determined using Doppler echocardiography before, one hour and 24  h after red blood cell transfusion. Blood pressure and haematocrit were also recorded at the same time. Mixed-effects regression model was used to analyse the effect of blood transfusion on left ventricular function and cardiac output.
Results:   57 preterm babies were recruited. Univariate analysis showed that cardiac index decreased significantly 24  h after transfusion ( P <0.05). Systemic red cell transport increased by an average of 11.1% 24  h after transfusion ( P <0.05). Multivariate analysis showed that the cardiac index was negatively associated with haematocrit and the index was higher in male babies.
Conclusion:   There was a significant drop in cardiac index and an increase in systemic red cell transport 24  h after transfusion in premature babies.