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Fetal hemoglobin levels in premature newborns. Should we reconsider transfusion of adult donor blood?

Gavulic, Amelia E. ; Dougherty, Danielle ; Li, Shih-Hon ; Carver, Alissa R. ; Bermick, Jennifer R. ; Mychaliska, George B. ; Hirschl, Ronald B. ; Perrone, Erin E.

Journal of pediatric surgery, 2021-11, Vol.56 (11), p.1944-1948 [Periódico revisado por pares]

United States: Elsevier Inc

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  • Título:
    Fetal hemoglobin levels in premature newborns. Should we reconsider transfusion of adult donor blood?
  • Autor: Gavulic, Amelia E. ; Dougherty, Danielle ; Li, Shih-Hon ; Carver, Alissa R. ; Bermick, Jennifer R. ; Mychaliska, George B. ; Hirschl, Ronald B. ; Perrone, Erin E.
  • Assuntos: Adult ; Adult hemoglobin (HbA) ; Blood Transfusion ; Erythrocyte Transfusion ; Extremely low gestational age newborn (ELGAN) ; Fetal Blood ; Fetal hemoglobin (HbF) ; Fetal Hemoglobin - analysis ; Gestational Age ; Humans ; Infant, Newborn ; Packed red blood cells (pRBCs) ; Transfusion
  • É parte de: Journal of pediatric surgery, 2021-11, Vol.56 (11), p.1944-1948
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: The aim of this study was to assess the percent decrease in fetal hemoglobin (HbF) after transfusion of adult-derived donor packed red blood cell (pRBC) units in extremely low gestational age newborns (ELGANs). Control percent fetal hemoglobin (%HbF) levels were measured in newborn cord blood or peripheral blood samples in non-transfused patients prior to elective surgery. ELGANs were followed prospectively and %HbF was measured on residual post-test complete blood count (CBC) specimens. ELGAN %HbF values were compared to the control population and transfusions were recorded. Initial mean %HbF in ELGANs (n=16) was 92.2±1.3% (range 90.2-95.1%), which is similar to the control group (n=25). Mean levels dropped to 61.1±11.1% (range 34.2-73.2%) after a single pRBC transfusion (n=9) and to a mean of 35.6±6.3% after an additional transfusion (n=5). %HbF levels trended upwards if no additional transfusions were given, but levels still remained lower than expected for gestational age through discharge (n=85 samples). Percent fetal hemoglobin concentrations in ELGANs decrease precipitously after transfusion with adult donor pRBCs. Further studies are needed to evaluate the benefit of maintaining higher fetal hemoglobin concentrations in these patients and whether administration of HbF rather than adult donor pRBCs would improve patient outcomes.
  • Editor: United States: Elsevier Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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