Lactic acid as a predictor for erythrocyte transfusion in healthy preterm infants with anemia of prematurity

ABSTRACT

Up till now there is no guidelines for blood transfusion in healthy preterm infants. In this study we try to show if blood lactate measurement may be used as in index for transfusion in those preterms. The present study included 33 healthy preterm infants, received no medications except for theophyline and prophylactic antibiotics, required no intravenous fluids or oxygen therapy. They were divided into two groups, [group I] included 23 babies, given once transfusion according to the decision of physician in charge. The main indications for transfusion were Hb below 8 gm/dl, Hct value below 30% and poor weight gain. The remaining 10 babies were not transfused [group II] and used as a control to measure normal blood lactate. The infants in the two groups were subjected to thorough history, clinical examination and selective laboratory investigations including CBC and blood lactate measurement. The results of group I were compared with each other before and after transfusion and with that obtained from group II. Comparing data of group I with that of group II, significant increase in blood lactate and decrease in Hb, Hct and body weight were detected in group I before blood transfusion. Pre and post transfusion data were compared in group I, there were significant decrease in blood lactate levels and significant increase in Hb, Hct and body weight, after transfusion. Blood lactate had a high specificity 100% and sensitivity 91.3%. We can conclude that measurement of blood lactate level as an indicator of early tissue hypoxia could identify otherwise healthy preterm infants who might benefit from blood transfusion. Thus, it may prevent unnecessary transfusion