Iatrogenic Massiv Blood Loss In Extremely Preterm Infants : Blood Sampling During The First Two Weeks Of Life

• Main Authors: Hellström, William, Forsell, L, Gebka, M, Morsing, E, Hellström, A, Ley, D
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.5b5f4338b56e9b005965b3e5

BackgroundNeonatal care administered to extremely preterm infants (EPT) has resulted in increased survival but in high rates of morbidity. Recent reports have indicated a correlation between a decrease in fetal hemoglobin, during the first weeks of life, with increased morbidity. The decrease has been suggested to be caused by transfusions. As blood sampling is related to transfusions the aim of the present project was to investigate the amount of blood sampling and transfusions in EPT during the first two weeks of life.Material and MethodsData will be presented from two cohorts of EPT (n=103) born at The Queen Silvia Childrenu2019s Hospital, Gothenburg (Table) and Sku00e5ne University Hospital, Lund, Sweden during 2009-18. The medical files were reviewed for cause and frequency of sampling and transfusions. Data is here presented from the Gothenburg cohort, similar preliminary results were seen in the Lund cohort.ResultsDuring postnatal days 1-14 mean (SD) blood sampling volume was 49.0 (25.8) ml/kg. The highest blood volume was taken during days 1-7 (32.1 ml/kg) as compared to days 8-14 (15.9 ml/kg), Figure 1. The major proportion of blood analyses was blood gases (37.9%), Figure 2. Days 1-14, the mean transfusion was 95.9 ml/kg (erythrocytes 70.7% and plasma 24.6%). ConclusionBlood sampling causes a blood withdrawal corresponding to 69.9 % of the EPTu2019s blood volume within the first two postnatal weeks whereas a majority during the first week of life. We speculate that important components in the fetal blood are iatrogenically lost and diluted and urge that further analyses of this problem are undertaken.