Post-transfusion white cell count in the sick preterm neonate.

Abstract

A previous report demonstrated post-transfusion leucocytosis as a potential confounding factor in the diagnosis of sepsis in critically ill adult patients. In We wished to establish if the same phenomenon occurred in the sick preterm neonate and whether this significantly altered the indices considered for potential neonatal infection. Transfusion and full blood count data in a level 3 neonatal intensive care unit were prospectively recorded for 3 months. One hundred and fourteen transfusion events were recorded from 37 infants. Median white blood cell count increased 0.9 x 109/L (confidence interval (CI) 0.4-2.4) in the first 8 h following transfusion (P = 0.032). Median neutrophil count increased by 0.4 x 109/L (CI 0.1-1.7) in the same 8 h (P = 0.05). Median neutrophil left shift decreased 1.2% (CI 1.1-5.8%) over the 24 h post-transfusion. No change in band count was observed. A mild post-transfusion white cell increase occurs in sick neonates. Because of the magnitude of effect, it is unlikely that this interesting physiological response would interfere with the diagnosis of sepsis in this population.