Journal article
Circulating RBC volume, measured with biotinylated RBCs, is superior to the Hct to document the hematologic effects of delayed versus immediate umbilical cord clamping in preterm neonates
Transfusion (Philadelphia, Pa.), Vol.43(8), pp.1168-1172
08/2003
DOI: 10.1046/j.1537-2995.2003.00454.x
PMID: 12869126
Abstract
BACKGROUND: One problem assessing the hematologic physiology of preterm infants after delivery and/or the efficacy and toxicity of therapeutic interventions affecting RBC measurements is the inability of blood Hct values to accurately reflect circulating RBC volume—owing to changes in plasma volume that influence Hct (i.e., a fall in plasma volume concentrates RBCs to increase Hct; a rise in plasma volume dilutes RBCs to decrease Hct).
STUDY DESIGN AND METHODS: As part of a randomized, clinical trial testing the hypothesis that delayed clamping of the umbilical cord at delivery expands neonatal circulating RBC volume, blood Hct was compared to circulating RBC volume results measured directly with autologous, biotinylated RBCs or estimated mathematically with neonatal body weight and Hct values in neonates after immediate or delayed (60 sec) cord clamping.
RESULTS: Circulating RBC volume measured directly with biotinylated RBCs significantly increased (p=0.04) in neonates after delayed (42.1 ± 7.8 mL/kg) versus immediate (36.8 ± 6.3 mL/kg) cord clamping—a difference not detected indirectly by measuring Hct or estimating circulating RBC volume mathematically.
CONCLUSIONS: Because true hematologic effects of delayed versus immediate cord clamping may not be apparent or may be misinterpreted, when based on indirect measurements of Hct or calculations of circulating RBC volume, it is important to measure circulating RBC volume directly—as done with autologous, biotinylated RBCs—to document whether delayed cord clamping truly results in a transfer of significant quantities of RBCs from placenta to neonate. The clinical benefits and potential toxicities of increased RBC transfer to neonates require further studies.
Details
- Title: Subtitle
- Circulating RBC volume, measured with biotinylated RBCs, is superior to the Hct to document the hematologic effects of delayed versus immediate umbilical cord clamping in preterm neonates
- Creators
- Ronald G Strauss - University of IowaDonald M Mock - Arkansas Children's HospitalKaren Johnson - University of Iowa Hospitals and ClinicsNell I Mock - University of Iowa Hospitals and ClinicsGretchen Cress - University of IowaLaura Knosp - University of Iowa Hospitals and ClinicsLori Lobas - University of Iowa Hospitals and ClinicsRobert L Schmidt - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Transfusion (Philadelphia, Pa.), Vol.43(8), pp.1168-1172
- Publisher
- Blackwell Publishing
- DOI
- 10.1046/j.1537-2995.2003.00454.x
- PMID
- 12869126
- ISSN
- 0041-1132
- eISSN
- 1537-2995
- Language
- English
- Date published
- 08/2003
- Academic Unit
- Stead Family Department of Pediatrics; Pathology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984622748802771
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