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Arch Dis Child Fetal Neonatal Ed 2000;82:F150-F155 ( March )

Haematocrit and red blood cell transport in preterm infants: an observational study

P Pladysa, A Beuchéea, E Wodeyb, L Tisona, P Bétrémieuxa

a Department of Paediatrics, Neonatal Unit, University Hospital, 35033 Rennes Cedex 09, France, b Department of Anesthesiology and Intensive Care 2, University Hospital

Correspondence to: Dr P Pladys, Unité de Réanimation Pédiatrique, Pavillon Le Chartier, CHU Pontchaillou, 35033 Rennes Cedex 09, France email: patrick.pladys{at}universal.fr

Accepted 28 October 1999

AIMS---To test whether cardiac output acts as a compensatory response to changes in haematocrit.
METHODS---A cohort of 38 preterm infants (27-31 weeks' gestation) was studied with repeated Doppler measurements of left ventricular output during the 1st month of life. Red blood cell transport was calculated when the duct was closed.
RESULTS---Multiple regression analysis showed that left ventricular output correlated negatively with haematocrit when the duct was closed (n = 84) and when it was open (n = 59). The influence of an increase of 10% in haematocrit absolute value on mean (SD) left ventricular output was estimated at -55 (11) ml/kg/min. Mean (SD) red blood cell transport was 132 (30) ml/kg/min with a mean (SD) intra-individual variability of 20% (8.8%). Red blood cell transport was increased more frequently by left ventricular output than by haematocrit. Haematocrit and left ventricular output but not red blood cell transport were dependent on postnatal age.
CONCLUSION---These results suggest that in preterm infants cardiac output adaptation is effective in attenuating the effects of red blood cell mass variations on systemic oxygen carrying capacity.


Key messages

  • Red cell transport is an estimation of oxygen carrying capacity
  • The effects of red blood cell mass variations on oxygen carrying capacity depend on the compensatory response provided by cardiac output adaptation




Keywords: prematurity; haematocrit; cardiac output; polycythaemia

© 2000 by Archives of Disease in Childhood


eLetters:

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A simple practice to increase red cell transport in newborns
Cory Mermer
Fetal Neonatal Ed. Online, 17 Mar 2000 [Full text]

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