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Unraveling the Fanconi anemia?DNA repair connection: Nature Genetics, Vol. 37, No. 9., pp. 921-922.Larry Thompson

Source: Nature Genetics, Vol. 37, No. 9., pp. 921-922.
Victor Herbert, MD, 1927-2002.: Am J Clin Nutr, Vol. 77, No. 4. (April 2003), pp. 757-759.CH Halsted

Source: Am J Clin Nutr, Vol. 77, No. 4. (April 2003), pp. 757-759.
Blood transfusion in late anemia of prematurity: effect on oxygen consumption, heart rate, and weight gain in otherwise healthy infants.: Infusionsther Transfusionsme d, Vol. 21, No. 6. (December 1994), pp. 376-379.BACKGR OUND: In premature infants there is no universally accepted definition of anemia requiring transfusion. We designed the present investigation to study the effects of red blood cell transfusion (based on simple transfusion rules) on weight gain, energy metabolism, and heart rate in otherwise healthy preterm infants. PATIENTS AND METHODS: We measured oxygen consumption (VO2), respiratory quotient (RQ) and energy expenditure (EE) by 4-hour indirect calorimetry, and assessed weight gain over 7 days and heart rate in 12 infants with late anemia of prematurity before and after red blood cell transfusion (10 ml/kg). At the time of transfusion, postmenstrual age was 38 +/- 1 weeks (mean +/- SEM), body weight 2.14 +/- 0.13 kg, and hemoglobin concentration 7.7 +/- 0.3 g/dl (range: 5.5-9.2). RESULTS: Red blood cell transfusion increased the hemoglobin concentration by 3.8 +/- 0.5 g/dl, but had no significant effect on weight gain (15.4 +/- 2.4 vs. 13.8 +/- 1.8 g/kg/day), VO2 (8.7 +/- 0.3 vs. 8.7 +/- 0.3 ml/kg/min), minimal VO2 (7.2 +/- 0.3 vs. 7.7 +/- 0.4 ml/kg/min), RQ (0.96 +/- 0.02 vs. 0.95 +/- 0.02), EE (50 +/- 2 vs. 51 +/- 2 kcal/kg/day), and heart rate (160 +/- 3 vs. 158 +/- 3 min-1). CONCLUSION: We conclude that oxygen supply and energy metabolism were not compromised in the anemic preterm infants at the time of red blood cell transfusion.T Böhler, A Janecke, O Linderkamp

Source: Infusionsther Transfusionsmed, Vol. 21, No. 6. (December 1994), pp. 376-379.
Haemodynamic effects of erythrocyte transfusion in preterm infants.: Eur J Pediatr, Vol. 163, No. 7. (July 2004), pp. 390-394.The aim of the study was to assess the short-term cardiorespirat ory effects of a standard red cell transfusion in very low birth weight (< 1500 g) infants undergoing intensive care. A total of 37 infants (birth weight 920 +/- 230 g, gestational age 27.8 +/- 2.1 weeks, age at study 6.1 +/- 3.9 days) with indwelling arterial lines were studied when 10 ml/kg of packed donor red cells were transfused based on clinical judgment. Infants with patent ductus arteriosus and/or inotropic treatment were excluded from the study. Oxygen saturation, left ventricular output, stroke volume, systolic, diastolic and mean arterial pressure, heart rate, and capillary refill time were assessed immediately prior to the transfusion and within an hour after the transfusion was completed. Capillary refill time after the transfusion was significantly shorter than prior to the transfusion (2.1 +/- 0.9 versus 2.4 +/- 1.0 s, P = 0.033). Left ventricular output, stroke volume and arterial pressures remained unaltered. Oxygen saturation after the transfusion was lower than before the transfusion (94.0 +/- 3.8 versus 95.3 +/- 2.5%, P = 0.014) despite unaltered oxygen supply. CONCLUSION: the data suggest that although a red cell transfusion of 10 ml/kg may marginally improve peripheral perfusion, it does not influence cardiac output and arterial blood pressure in normotensive preterm infants. It may, however, cause a transient decrease in oxygen saturation.JA Leipälä, T Boldt, V Fellman

Source: Eur J Pediatr, Vol. 163, No. 7. (July 2004), pp. 390-394.
The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants.: J Pediatr, Vol. 149, No. 3. (September 2006), pp. 301-307.OBJECT IVE: To determine whether extremely low birth weight infants (ELBW) transfused at lower hemoglobin thresholds versus higher thresholds have different rates of survival or morbidity at discharge. STUDY DESIGN: Infants weighing

Source: J Pediatr, Vol. 149, No. 3. (September 2006), pp. 301-307.
Weight gain: a response to transfusion in selected preterm infants.: Am J Dis Child, Vol. 138, No. 9. (September 1984), pp. 828-830.A group of low-birth-weig ht infants with daily weight gains that were below the expected mean for postnatal age were examined to determine the effects of RBC transfusion on their weight gain. The mean hemoglobin concentration (+/- SD) in 13 infants (birth weight less than 1,500 g) prior to transfusion was 8.5 +/- 1.6 g/dL and 11.4 +/- 2.1 g/dL after transfusion. When a comparison was made between the daily weight gain for the week prior to transfusion with the week following transfusion, the mean daily weight gain (+/- SD) increased from 20.8 +/- 4.6 g to 28.0 +/- 6.3 g. Among the six infants with pretransfusion hemogloblin concentrations of less than 7.5 g/dL, the increase in daily weight gain was greatest (a rise from 22.6 +/- 4.0 g to 34.1 +/- 4.9 g). Improvements in weight gain were associated with a decrease in metabolic rates as determined by declines in oxygen consumption.JA Stockman, DA Clark

Source: Am J Dis Child, Vol. 138, No. 9. (September 1984), pp. 828-830.
Red blood cell transfusions for preterm infants: the role of evidence-based medicine.: Semin Perinatol, Vol. 21, No. 1. (February 1997), pp. 8-19.Increasin gly clinicians attempt to base decisions regarding patient management on the results of clinical studies in addition to expert opinion and their own practical experience. In this article, the author reviews the published studies available to assist clinicians to make evidence-based decisions in three topics related to small volume red blood cell (RBC) transfusions for preterm infants; namely, studies examining the effects of RBC transfusions on possible symptoms of anemia such as tachypnea, apnea or other cardiorespirat ory irregularities , studies investigating the collection and transfusion of umbilical cord blood and finally studies addressing the duration of storage and use of additive solutions for RBCs for transfusion to neonates. Based on the review of these studies, guidelines for small volume RBC transfusions in preterm infants are suggested.H Hume

Source: Semin Perinatol, Vol. 21, No. 1. (February 1997), pp. 8-19.
Effect of booster blood transfusions on oxygen utilization in infants with bronchopulmona ry dysplasia.: J Pediatr, Vol. 113, No. 4. (October 1988), pp. 722-726.To assess the impact of booster transfusions on oxygen utilization in infants with bronchopulmona ry dysplasia, we noninvasively measured oxygen consumption (VO2) and the variables of systemic oxygen transport (SOT) before and 24 hours after transfusion therapy in 10 oxygen-depende nt infants with bronchopulmona ry dysplasia. The infants had been born with a mean gestational age of 27.6 weeks and a mean birth weight of 0.88 kg. Study weight averaged 1.24 +/- 0.35 kg, and study age averaged 5.5 +/- 2.4 weeks. Requirements for fractional concentration of inspired oxygen averaged 0.41 +/- 0.15 to maintain an oxygen saturation of 0.93 +/- 0.02. The VO2 was measured by means of a commercially available analyzer through a flow-through circuit and pump connected to a hood or in line with the ventilator. Cardiac output was calculated by means of pulsed Doppler ultrasonograph y. Oxygen saturation was measured by means of transcutaneous pulse oximetry. The coefficient of oxygen utilization was calculated as VO2/SOT. Transfusion consisted of packed erythrocytes (10 ml/kg). Oxygen utilization fell in all subjects after transfusion (p less than 0.01), but it fell more substantially in subjects with higher coefficients of oxygen utilization (r = -0.80, p less than 0.01), suggesting a physiologic benefit in selected patients, particularly those with higher levels of oxygen utilization. There was also a significant increase in overall systemic oxygen transport (p less than 0.01) and decrease in VO2 (p less than 0.02). Hemoglobin levels alone did not correlate with overall systemic oxygen transport, VO2, or level of oxygen use before transfusion, and thus did not predict which subjects would have a physiologic benefit from transfusion as reflected by falls in oxygen utilization.DC Alverson, VH Isken, RS Cohen

Source: J Pediatr, Vol. 113, No. 4. (October 1988), pp. 722-726.
The relationship between hematocrit and bleeding time in very low birth weight infants during the first week of life.: J Perinatol, Vol. 21, No. 6. (September 2001), pp. 368-371.OBJECT IVES: The bleeding time is a measurement of platelet and capillary interaction following a small standardized cutaneous incision. In adults, anemia causes a prolongation of the bleeding time, and we hypothesized that the same would be true in very low birth weight (VLBW) infants during their first week of life. STUDY DESIGN: Template bleeding times, using the Surgicutt Newborn device, were performed on 20 VLBW weight infants

Source: J Perinatol, Vol. 21, No. 6. (September 2001), pp. 368-371.
Etiology of Anemia in Patients With Advanced Heart Failure: J Am Coll Cardiol, Vol. 48, No. 12. (19 December 2006), pp. 2485-2489.OBJE CTIVES: We prospectively investigated the causes of anemia in patients with advanced congestive heart failure (CHF). BACKGROUND: Anemia is common in patients with advanced CHF, and its etiology is generally considered to be multifactorial . However, despite its importance, precise information is lacking regarding the prevalence of putative etiologic factors. METHODS: Patients who were hospitalized for decompensated advanced CHF and who were stabilized after their initial treatment underwent evaluation of "clinically significant" anemia, defined as a hemoglobin content

Source: J Am Coll Cardiol, Vol. 48, No. 12. (19 December 2006), pp. 2485-2489.

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