Journal of perinatology : official journal of the California Perinatal Association
-
Sick neonates often require periodic small volume transfusions (10 mL/kg) to replace blood drawn for laboratory monitoring during their hospital stay. We use red blood cells (RBCs), stored as CPDA-1 whole blood, up to their expiration date, and are unaware of any clinical problems with this practice. We proceeded to confirm our clinical impression by reviewing the hospital records of 22 transfused neonates who received a median of 2.5 RBC transfusions (range 1 to 11) with a volume of 16 mL (range 5 to 38) each, and total volume of 60 mL (range 16 to 152). ⋯ Paradoxically, RBCs over 10 days of age resulted in a fall in potassium (-0.9 +/- 0.8 mEq/L, P less than .01), but not below 3.4 mEq/L. We could find no evidence by clinical observation or laboratory indexes that small volume transfusion of RBCs more than 5 days old was deleterious to the newborns studied. By using RBCs up to their expiration date, the number of donor exposures and the potential risk of transfusion-transmitted diseases can be decreased.
-
The precordial stethoscope allows direct monitoring of infants in the delivery room during neonatal resuscitation. The use of this monitor is already mandated as a standard of care practice in pediatric and adult anesthesia. ⋯ The routine use of the precordial stethoscope during infant resuscitation in the delivery room may improve quality of care, especially pertaining to airway management, in an area otherwise devoid of monitors. It may be useful in other pediatric resuscitation settings and when transporting ill or sedated pediatric patients.