Feasibility of red blood cell transfusion through small bore central venous catheters used in neonates

Edward C.C. Wong, Seth Schreiber, Valli R. Criss, Bonnie LaFleur, K. Rais-Bahrami, Billie Short, Naomi L.C. Luban

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: To determine whether packed red blood cell transfusions through small-bore central venous catheters used in critically ill neonates results in significant hemolysis. Design: In vitro experimental study using a mock transfusion setup incorporating a syringe pump, prestorage leukoreduced fresher, and older CPDA-1 red blood cell units and pressure transducer simulating neonatal transfusion through 1.9-Fr NeoPICC central venous catheter. Setting: Laboratory setting. Subjects: None. Interventions: None. Measurements and Main Results: Spun hematocrit, plasma free hemoglobin (hemoglobin), lactate dehydrogenase, and potassium were analyzed pretransfusion, at various times during transfusion, and posttransfusion. Intraluminal pressures were measured using a TruWave Disposable Pressure Transducer. Using fresher (5-8 days old) and older (29-30 days old) CPDA-1 red blood cells, we compared 2 and 20 mL/hr flow rates. Statistical analysis was performed using repeated measures of analysis of variance to compare the differences in means between flow rates. Mean intraluminal pressures at the end of each experiment were significantly higher at 20 mL/hr flow rates (>360 mm Hg) in both fresher and older red blood cells than at 2 mL/hr (range, 61-70 mm Hg). Overall, potassium, lactate dehydrogenase, and plasma free hemoglobin concentrations were significantly higher for older red blood cells at either 2 or 20 mL/hr (p < .001). Both fresher and older red blood cells demonstrated higher potassium concentrations at 20 mL/hr (22.4%, p < .001; and 0.7%, p > .05, respectively); however, these increases were not clinically significant. Furthermore, lactate dehydrogenase, hematocrit, and plasma free hemoglobin differences seen at 2 and 20 mL/hr did not coincide with changes in potassium. Conclusions: No clinically significant hemolysis was evidenced with red blood cell transfusion through small-bore central venous catheters when using fresher or older CPDA-1 red blood cells at 2 or 20 mL/hr.

Original languageEnglish (US)
Pages (from-to)69-74
Number of pages6
JournalPediatric Critical Care Medicine
Volume5
Issue number1
DOIs
StatePublished - 2004
Externally publishedYes

Keywords

  • Blood
  • Hemolysis
  • Newborn
  • Potassium
  • Red blood cell transfusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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