Effect of blood transfusion on children's arterial blood gases on PICU
Research type
Research Study
Full title
Effect of blood transfusion on children's arterial blood gases on a paediatric intensive care unit
IRAS ID
143854
Contact name
Michael Griksaitis
Contact email
Sponsor organisation
R&D Office
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Up to 13% of children on paediatric intensive care units (PICUs) receive blood transfusions, the majority in the first 72 hours following admission. There are many potential complications associated with the transfusion of donor Red Blood Cell (RBC's), including infection, immune mediated transfusion reactions and metabolic derangement. The metabolic derangement may be as a consequence of the biochemical changes that occur when donated blood is stored in blood banks. These include an increase in acidity and potassium concentration. These changes effect the function of RBC’s and some data from adult studies suggest that massive transfusion can affect the biochemistry of the recipient leading for example to a metabolic acidosis and dangerously high serum potassium.
There are no data about the metabolic effects of blood transfusion in children. The circulating volume of a child is 80 ml/kg (800 ml in a 10 kg child) and that of an adult 60 ml/kg (4200 ml in a 70 kg adult). It might be expected that as the volume of blood typically transfused (15 ml/kg = 150 ml in a 10 kg child) in children is significantly larger in comparison to their circulating blood volume (19%) than in adults (500 ml = 12%), that the metabolic effects of transfusion might be greater.
The metabolic effects of RBC transfusion are partly due to a chemical called citrate, used to anticoagulate stored RBCs. Citrate increases blood acidity but is removed by the liver. The liver in children is obviously smaller than in adults and its enzyme systems are also less mature. This might also exaggerate the metabolic effects of blood transfusion.
For these reasons and because these effects have not been previously studied in children we wish to do this pilot study. It may further inform transfusion practice or form the basis for a larger trial.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
15/NE/0026
Date of REC Opinion
20 Jan 2015
REC opinion
Favourable Opinion