Journal article
Adaptive responses during anemia and its correction in lambs
Journal of applied physiology (1985), Vol.88(4), pp.1397-1406
04/01/2000
DOI: 10.1152/jappl.2000.88.4.1397
PMID: 10749835
Abstract
There is limited information available on which to base decisions regarding red blood cell (RBC) transfusion treatment in anemic newborn infants. Using a conscious newborn lamb model of progressive anemia, we sought to identify accessible metabolic and cardiovascular measures of hypoxia that might provide guidance in the management of anemic infants. We hypothesized that severe phlebotomy-induced isovolemic anemia and its reversal after RBC transfusion result in a defined pattern of adaptive responses. Anemia was produced over 2 days by serial phlebotomy (with plasma replacement) to Hb levels of 30–40 g/l. During the ensuing 2 days, Hb was restored to pretransfusion baseline levels by repeated RBC transfusion. Area-under-the-curve methodology was utilized for defining the Hb level at which individual study variables demonstrated significant change. Significant reciprocal changes ( P < 0.05) of equivalent magnitude were observed during the phlebotomy and transfusion phases for cardiac output, plasma erythropoietin (Epo) concentration, oxygen extraction ratio, oxygen delivery, venous oxygen saturation, and blood lactate concentration. No significant change was observed in resting oxygen consumption. Cardiac output and plasma Epo concentration increased at Hb levels <75 g/l, oxygen delivery and oxygen extraction ratio decreased at Hb levels <60 g/l, and venous oxygen saturation decreased and blood lactate concentration increased at Hb levels <55 g/l. We speculate that plasma Epo and blood lactate concentrations may be useful measures of clinically significant anemia in infants and may indicate when an infant might benefit from a RBC transfusion.
Details
- Title: Subtitle
- Adaptive responses during anemia and its correction in lambs
- Creators
- John A. Widness - University of IowaLance S. Lowe - Departments of Pediatrics andEdward F. Bell - Departments of Pediatrics andLeon F. Burmeister - University of IowaDonald M. Mock - Arkansas Children's HospitalJames A. Kistard - Iowa Statewide Organ Procurement Organization, Iowa City, Iowa 52245;Harry Bard - Université de Montréal
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985), Vol.88(4), pp.1397-1406
- DOI
- 10.1152/jappl.2000.88.4.1397
- PMID
- 10749835
- ISSN
- 8750-7587
- eISSN
- 1522-1601
- Language
- English
- Date published
- 04/01/2000
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984354148802771
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