Post-transfusion hemoglobin estimation in Filipino children and adolescents using an alternative red cell volume transfusion formula

Maria Beatriz    P. Gepte,; Michael  C. Cuarteron,; Caroline  T. Hernandez,

Post-transfusion hemoglobin estimation in Filipino children and adolescents using an alternative red cell volume transfusion formula

Michael C. Cuarteron | Caroline T. Hernandez | Maria Beatriz P. Gepte

Abstract:

BACKGROUND AND OBJECTIVE: Conventional red cell transfusion formulae used in clinical practice has shown underestimation of the actual post-transfusion hemoglobin level. To address this problem, we aimed to determine if there is an agreement between computed and actual post-transfusion hemoglobin levels using an alternative red cell transfusion formula. METHODOLOGY: This was a prospective, cross-sectional study. Using Morris’ formula, the red cell volume requirements of the participants were computed and post-transfusion hemoglobin levels were obtained for comparison. RESULT: Majority of the 116participants belongs to age between 2 to 5 years (39.5%) and female (54.3%). Most common indication was hemoglobin level < 7 g/dL with manifestations of anemia (56%). The computed and actual post-transfusion hemoglobin were in agreement. The increase in hemoglobin had direct relationship to the volume of blood transfused and inverse relationship to the age and weight of the patients. CONCLUSION: Using Morris’ formula, the computed and actual post-transfusion hemoglobin values were in agreement. The volume of transfused red cells, age, and weight are predictors of the increase in post-transfusion hemoglobin. This formula can be adopted for Filipino pediatric patients and can obviate the need for hemoglobin determination after transfusion.

References:

Strauss RG. Red blood cell transfusions and erythropoietin therapy. In: Nelson Textbook of Pediatrics. 19^th ed. Philadelphia: WB Saunders Company; 2011:1692–1693.
Hume HA. Blood components: preparation, indications and administration. In: Pediatric Hematology. 2^nd ed. London: Churchill Livingstone; 1999:709–737.
Walker R. Mathematical calculations in transfusion medicine. Clin Lab Med. 1996;16:895–906.
King DJ. Disorders of the blood and reticuloendothelial system. In: Forfar & Arneill’s Textbook of Pediatrics. 5^th ed. London: Churchill Livingstone; 1998:847–883.
Luban NLC, DePalma L. Transfusion therapy in the pediatric intensive care unit. In: Holbrook PR, ed. Textbook of Pediatric Critical Care. Philadelphia: WB Saunders Company; 1993:773–782.
Morris KP, Naqvi N, Davies P, Smith N, Lee PW. A new formula for blood transfusion volume in the critically ill. Arch Dis Child. 2005;90:724–728.
Bolton-Maggs PHB, Murphy MF. Blood transfusion. Arch Dis Child. 2004;89:4–7.
Davies P, Robertson S, Hegde S, et al. Calculating the required transfusion volume in children. Transfusion. 2007;47:212–216.
British Committee for Standards in Haematology. Transfusion guidelines for neonates and older children. Br J Haematol. 2004;124:433–453.
McIntosh N, Helms P, Smyth R, editors. Forfar and Arneil’s Textbook of Pediatrics. 6^th ed. London: Churchill Livingstone; 2003.
Lacroix J, Hébert PC, Hutchison JS, et al.; TRIPICU Investigators; Canadian Critical Care Trials Group; Pediatric Acute Lung Injury and Sepsis Investigators Network. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 2007;356(16):1609–1619.
Dallman PR, Barr GD, Allen CM, Shinefield HR. Hemoglobin concentration in white, black, and Oriental children: Is there a need for separate criteria in screening for anemia? Am J Clin Nutr. 1978;31(3):377–380.
Grunau RE, Holsti L, Peters JW. Long-term consequences of pain in human neonates. Semin Fetal Neonatal Med. 2006;11:268–275.
Schechter NL, Allen DA, Hanson K. Status of pediatric pain control: A comparison of hospital analgesic usage in children and adults. Pediatrics. 1986;77:11–15.
Valeri CR. Viability and function of preserved red blood cells. N Engl J Med. 1971;284:81–88.
Hamasaki N, Yamamoto M. Red blood cell function and blood storage. Vox Sang. 2000;79:191–197.
Hulley SB, Cummings SR, Browner WS, Grady D, Newman TB. Designing Clinical Research: An Epidemiologic Approach. 4^th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Appendix 6A:79.