Use of SAG-M-suspended red cell concentrate in large volume transfusion associated with cardiac surgery in neonates and infants: a retrospective audit.

摘要

Modern cardiothoracic surgical techniques allow correction of increasingly complex congenital cardiac defects with a resultant requirement for large volume red cell concentrate (RCC) transfusion. Transfusion of RCC in the neonatal and infant period is associated with a number of particular concerns (Luban, 2002), some of which relate specifically to the use of anticoagulant/preservative solutions, such as citrate-phosphate-dextrose (CPD) and s aline-adenine-glucose-mannitol (SAG-M), used to prolong RCC shelf-life. The solute load of CPD and SAG-M could theoretically cause electrolyte disturbance or promote an osmotic diuresis, resulting in an increased risk of periventricular haemorrhage secondary to changes in intracerebral pressure (Luban et al, 1991). Adenine and mannitol have been associated with nephrotoxicity in animal experiments when administered in high concentrations (Yokozawa etal., 1986), whereas it has been calculated that the concentrations of solutes could reach toxic levels when used in the context of large volume transfusion (Luban et al., 1991).