Abstract
Background - We measured trends in continuous vital sign parameters and hemoglobin concentration in adult patients before and after 1- and 2-unit red cell (RBC) transfusions.
Materials and methods - A multi-center longitudinal study of 72 patients connected to a remote continuous monitoring service transfused 1 or 2 RBC units. Primary outcome was changes in heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2), and secondary outcome was changes in hemoglobin concentration.
Results - Fifty-one patients received 1 RBC unit, 21 received 2 units. During the 10-hour pre-single-unit transfusion period, there were no clinically meaningful trends in HR (0.05, 95% CI, −0.36 to 0.46), RR (0.13, 95% CI, 0.02 to 0.25), or SpO2 (0.08%, 95% CI, −0.02 to 0.18). There were no clinically meaningful differences in trends in the 24-hour period post-single-unit RBC transfusion when compared to the pre-transfusion trend (HR: 0.03, 95% CI, −0.44 to 0.51; RR: −0.09, 95% CI, −0.22 to 0.05; SpO2: −0.15%, 95% CI, −0.27 to −0.02). The mean hourly hemoglobin trend 48 hours pre-single-unit transfusion was −0.07 g/dL (95% CI, −0.09 to −0.05) and 0.08 g/dL (95% CI, 0.05 g/dL to 0.10 g/dL) in the 48 hours post transfusion when compared to the pre-transfusion trend. Similar results were observed pre- and post-double-unit RBC transfusion.
Discussion - Despite hemoglobin concentration declines pre-single and double-unit RBC transfusion, and expected increases post-transfusion, there were no clinically meaningful trends in vital signs in the 10 hours before single- or double-unit transfusion or changes in trend in vital signs 24 hours post-transfusion.
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Authors
Kevin Trentino
East CareConnect, East Metropolitan Health Service, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
Adam Lloyd East CareConnect, East Metropolitan Health Service, Perth, Australia
Kevin Murray School of Population and Global Health, The University of Western Australia, Perth, Australia
Grant Waterer Medical School, The University of Western Australia, Perth, Australia; East Metropolitan Health Service, Perth, Australia
Shannon Farmer Discipline of Surgery, Medical School, The University of Western Australia, Perth, Australia; Department of Hematology, Royal Perth Hospital, Perth, Australia
Michael Leahy Medical School, The University of Western Australia, Perth, Australia; Department of Haematology, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, Australia
Wayne Dyer
Discipline of Surgery, Medical School, The University of Western Australia, Perth, Australia; Australian Red Cross Lifeblood, Sydney, Australia; Kirby Institute, University of NSW, Sydney, Australia
Jonathon Burcham East CareConnect, East Metropolitan Health Service, Perth, Australia
Tim Bowles East CareConnect, East Metropolitan Health Service, Perth, Australia; Critical Care, Royal Perth Bentley Group, Perth, Australia
Wendy Erber Department of Hematology, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, Australia; School of Biomedical Sciences, The University of Western Australia, Perth, Australia
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