Effect of Blood Transfusion on Apnea, Bradycardia and Hypoxemia in Preterm Infants 197

Abstract

Objective: To study the effect of blood transfusion on the frequency of apnea, bradycardia and hypoxemia. Patients: 21 spontaneously breathing preterm infants, median GA at birth 28 (range 23.31) wk, age at study 22 d (3.84), weight at study 925 g (640-2120), who exhibited frequent episodes of bradycardia and/or hypoxemia and were anemic (median hemoglobin level 109 (82-120) g/l). Methods: 4 h recordings of pulse oximeter saturation (SpO2), pulse waveforms, ECG, breathing movements and nasal airflow immediately before and after transfusion, and again after a further interval of 12 h. Analysis of recordings for isolated and periodic apneas (>4 s), bradycardias (heart rate <2/3 of baseline), and episodic desaturation (SpO2 ≤80%). Results: There were no significant changes in the frequency of apnea, bradycardia or desaturation following transfusion. There was also no significant change in the severity and/or duration of apnea or bradycardia. The average SpO2 nadir reached during each desaturation, however, increased by 3% following transfusion (p<0.05), and there was a trend towards shorter desaturations. Conclusion: There was no clinically significant effect of blood transfusion on apnea, bradycardia or hypoxemia in these relatively young and mildly anemic preterm infants. These data suggest that the occurrence of frequent episodes of apnea, bradycardia and/or hypoxemia does not, on its own, justify a blood transfusion in mildly anemic preterm infants.