Yazdanbakhsh Mahsa, Eid Haytham, Acker Jason P, Bar Am Neta, Cheung Po-Yin, Dotchin Stephanie A, Rabi Yacov
Innovation and Portfolio Management, Canadian Blood Services, Edmonton, AB, Canada.
Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
Pediatr Res. 2024 Oct 23. doi: 10.1038/s41390-024-03646-x.
Despite preterm newborns often requiring blood transfusions, we have an incomplete understanding of the impact of adult packed red blood cell (pRBC) transfusions on fetal red blood cell (RBC) oxygen affinity. We investigated the influence of adult pRBC on oxygen binding in fetal RBCs obtained from the umbilical cord of preterm newborns. This included exploring the influence of the biological age of adult pRBCs on the oxygen affinity of fetal blood.
Cord blood samples from preterm infants were titrated with young (Y-RBC) and old (O-RBC) adult pRBCs using an in vitro transfusion model. Parameters, including oxygen affinity (p50), hemoglobin variants, and red blood cell indices, were measured.
The titration of cord blood with adult pRBCs (n = 19) resulted in a concentration-dependent decrease in p50, indicating an increased oxygen affinity. Hemoglobin variant analysis revealed a shift in composition, with a decrease in fetal hemoglobin (HbF) and an increase in adult hemoglobin (HbA) following titration.
The impact of biological age was evident, as O-RBCs had a more pronounced effect on p50 values compared to Y-RBCs. Understanding the physiologic implications of transfusing preterm infants with adult pRBCs is important for optimizing transfusion practices in newborns.
In an in vitro model, titrating adult pRBC into fetal blood significantly affects oxygen binding Oxygen affinity of fetal blood is significantly increased after titration of adult pRBC. Compared to older RBC subpopulations of adult pRBC, oxygen-binding properties of younger RBC subpopulations of adult pRBC more closely approximate the oxygen affinity of fetal blood. This work highlights the importance of investigating the influence of adult pRBC transfusion on fetal RBC oxygen binding. This may have implications for morbidities in the newborn period related to oxygen physiology.
尽管早产新生儿常常需要输血，但我们对成人浓缩红细胞（pRBC）输血对胎儿红细胞（RBC）氧亲和力的影响了解并不完全。我们研究了成人pRBC对从早产新生儿脐带获取的胎儿RBC中氧结合的影响。这包括探究成人pRBC的生物学年龄对胎儿血液氧亲和力的影响。
使用体外输血模型，用年轻（Y-RBC）和年老（O-RBC）的成人pRBC对早产婴儿的脐带血样本进行滴定。测量包括氧亲和力（p50）、血红蛋白变体和红细胞指数等参数。
用成人pRBC（n = 19）对脐带血进行滴定导致p50呈浓度依赖性降低，表明氧亲和力增加。血红蛋白变体分析显示成分发生变化，滴定后胎儿血红蛋白（HbF）减少，成人血红蛋白（HbA）增加。
生物学年龄的影响很明显，因为与Y-RBC相比，O-RBC对p50值的影响更显著。了解给早产婴儿输注成人pRBC的生理影响对于优化新生儿输血实践很重要。
在体外模型中，将成人pRBC滴定到胎儿血液中会显著影响氧结合。滴定成人pRBC后，胎儿血液的氧亲和力显著增加。与成人pRBC中较老的RBC亚群相比，成人pRBC中较年轻的RBC亚群的氧结合特性更接近胎儿血液的氧亲和力。这项工作强调了研究成人pRBC输血对胎儿RBC氧结合影响的重要性。这可能对新生儿期与氧生理学相关的发病率有影响。
