Abstract
If oxygen delivery to the central nervous system is reduced because of anaemia of prematurity recurrent apnoea, bradycardia and tachycardia may become more prominent clinically. The purpose of this prospective study was to evaluate the effect of blood transfusions on apnoea, bradycardia and tachycardia frequencies in 25 anaemic premature infants (gestational age 29±3, birth weight 1170g xyp 550, age at transfusion 32 ± 16 days).
Methods: The premature infants received 10 ml red blood cells per kilogram of body weight over a 3 hour period. The frequency of apnoeas >10s, bradycardias <100 min−1 and tachycardias >200 min−1 were documented on an event recorder (Eden Tec 2000W, Minneapolis, USA) over a period of 72 hours. The event recorder allowed the recording of pneumocardiograms and revaluation of each event. The events were distinguished in apnoeas of 10 to 15s and more than 15s duration, bradycardias <80 and <100 min−1. Oxygen saturation was documented during each event. No event recording was done at the day of transfusion.
Results: We found significant decreases in frequencies of apnoeas >15s (2,7 to 0,9 per day), tachycardias >200 min−1 (34 to 25 per day) bradycardias <100 min−1 (65 to 12 per day) and <80 min−1 (8,4 to 3,3 per day) using Wilcoxon-rank-test. Both types of bradycardia, caused by central apnoea or even by mixed or obstructive apnoea, will be effected by blood transfusion. There is no effect on periodic breathing and apnoeas of 10 to 15s, probably caused to methodology faults. Prevention of marked oxygen desaturation was ameliorated in some infants, the difference is statistical significant. The effects of transfusion remained for three days. This suggests that the beneficial effects of transfusion were not solely due to volume expansion. Day-to-day variability is not significant three days before and three days after transfusion.
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Stute, H., Greiner, B. & Linderkamp, O. 367 EFFECT OF BLOOD TRANSFUSION ON APNOEA, BRADYCARDIA, TACHYCARDIA AND OXYGEN SATURATION. Pediatr Res 36, 64 (1994). https://doi.org/10.1203/00006450-199407000-00367
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DOI: https://doi.org/10.1203/00006450-199407000-00367