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.