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Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

Hellström, William ; Forssell, Linnéa ; Morsing, Eva LU ; Sävman, Karin and Ley, David LU (2019) In Acta Paediatrica, International Journal of Paediatrics
Abstract

Aim: Studies indicate that reduced foetal haemoglobin levels are related to increased neonatal morbidity rates. This study investigated the relationships between sampling-related blood loss and adult blood transfusions administered during postnatal days 1-14 and the development of severe neonatal morbidities in extremely preterm infants born before 28 weeks of gestation. Methods: The medical files of 149 extremely preterm infants born at two university hospitals in Sweden from 2013 to 2018 were investigated. Results: Blood sampling resulted in a 58% depletion of the endogenous blood volume postnatal days 1-14 (median 40.4 mL/kg, interquartile range 23.9-53.3 mL/kg) and correlated with the adult erythrocyte transfusion volume... (More)

Aim: Studies indicate that reduced foetal haemoglobin levels are related to increased neonatal morbidity rates. This study investigated the relationships between sampling-related blood loss and adult blood transfusions administered during postnatal days 1-14 and the development of severe neonatal morbidities in extremely preterm infants born before 28 weeks of gestation. Methods: The medical files of 149 extremely preterm infants born at two university hospitals in Sweden from 2013 to 2018 were investigated. Results: Blood sampling resulted in a 58% depletion of the endogenous blood volume postnatal days 1-14 (median 40.4 mL/kg, interquartile range 23.9-53.3 mL/kg) and correlated with the adult erythrocyte transfusion volume (rS = 0.870, P <.001). Sampling-related blood loss on postnatal days 1-7, adjusted for gestational age at birth and birth weight standard deviation score, was associated with the development of bronchopulmonary dysplasia (BPD) (odds ratio by a 10-unit increase 2.4, 95% confidence interval 1.1-5.4) (P =.03). No associations were found between blood sampling and intraventricular haemorrhage or necrotising enterocolitis in the full statistical model. The largest proportion of sampling-related blood was used for blood gas analyses (48.7%). Conclusion: Diagnostic blood sampling led to major endogenous blood loss replaced with adult blood components and was associated with the development of BPD.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
anaemia, blood sampling, bronchopulmonary dysplasia, extremely preterm, transfusion
in
Acta Paediatrica, International Journal of Paediatrics
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • scopus:85073929106
  • pmid:31505053
ISSN
0803-5253
DOI
10.1111/apa.15003
language
English
LU publication?
yes
id
8e2ea846-c39e-4b78-b16e-d0550bed3e60
date added to LUP
2019-11-07 09:51:43
date last changed
2019-11-25 09:35:35
@article{8e2ea846-c39e-4b78-b16e-d0550bed3e60,
  abstract     = {<p>Aim: Studies indicate that reduced foetal haemoglobin levels are related to increased neonatal morbidity rates. This study investigated the relationships between sampling-related blood loss and adult blood transfusions administered during postnatal days 1-14 and the development of severe neonatal morbidities in extremely preterm infants born before 28 weeks of gestation. Methods: The medical files of 149 extremely preterm infants born at two university hospitals in Sweden from 2013 to 2018 were investigated. Results: Blood sampling resulted in a 58% depletion of the endogenous blood volume postnatal days 1-14 (median 40.4 mL/kg, interquartile range 23.9-53.3 mL/kg) and correlated with the adult erythrocyte transfusion volume (r<sub>S</sub> = 0.870, P &lt;.001). Sampling-related blood loss on postnatal days 1-7, adjusted for gestational age at birth and birth weight standard deviation score, was associated with the development of bronchopulmonary dysplasia (BPD) (odds ratio by a 10-unit increase 2.4, 95% confidence interval 1.1-5.4) (P =.03). No associations were found between blood sampling and intraventricular haemorrhage or necrotising enterocolitis in the full statistical model. The largest proportion of sampling-related blood was used for blood gas analyses (48.7%). Conclusion: Diagnostic blood sampling led to major endogenous blood loss replaced with adult blood components and was associated with the development of BPD.</p>},
  author       = {Hellström, William and Forssell, Linnéa and Morsing, Eva and Sävman, Karin and Ley, David},
  issn         = {0803-5253},
  language     = {eng},
  month        = {09},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Paediatrica, International Journal of Paediatrics},
  title        = {Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia},
  url          = {http://dx.doi.org/10.1111/apa.15003},
  doi          = {10.1111/apa.15003},
  year         = {2019},
}