Abstract
BACKGROUNDGamma irradiation of red blood cells (RBCs) is well recognized to exacerbate storage lesion formation, but the effect of storage after irradiation on in vivo oxygen delivery capacity of transfused RBCs is currently not known.
STUDY DESIGN AND METHODSIn 24 preterm infants with anemia receiving nonurgent transfusion of irradiated RBCs, we examined cerebral regional tissue oxygenation (crSO(2)) and time spent with peripheral arterial saturation (SpO(2)) less than 88%. Physiologic data were obtained immediately before, immediately after, and 5 days after transfusion.
RESULTSWe observed linear negative moderate correlations between time since irradiation and the magnitude of change in crSO(2) (r=-0.60; 95% CI, -0.81 to -0.27; p=0.0018) and time spent with SpO(2) of less than 88% (r=-0.42; 95% CI, -0.71 to 0.003; p=0.04) immediately after transfusion. In infants (n=9) who received fresher RBCs (irradiated<10 days before transfusion), there was a sustained increase in mean crSO(2) up to 5 days after transfusion (3.0%; 95% CI, 0.3% to 5.7%; p=0.04). Conversely, in infants (n=15) who received older RBCs (irradiated10 days before transfusion), there were negligible changes in crSO(2) after transfusion at any time point.
CONCLUSIONOur findings indicate that storage after gamma irradiation may have a detrimental effect on the oxygen delivery capacity of RBCs given to anemic preterm infants.