Bard H, Fouron J C, Chessex P, Widness J A
Neonatology and Cardiology Services, Hôpital Sainte-Justine, University of Montreal, Canada.
J Pediatr. 1998 Apr;132(4):630-4. doi: 10.1016/s0022-3476(98)70351-8.
The effects of anemia of prematurity during bronchopulmonary dysplasia (BPD) as well as on the metabolic and erythropoietic functions were determined before and after a transfusion. Fourteen anemic (Hb range: 65-88 gm/L), oxygen dependent (fraction of inspired oxygen < or = 35%), nonventilated, preterm infants with BPD were studied at a postnatal age of 6 +/- 2 weeks.
Cardiac output, heart rate, mean velocity of circumferential fiber shortening, shortening fraction (SF), and stroke volume were assessed by pulsed and continuous wave Doppler echocardiography. Values for resting oxygen consumption, carbon dioxide production, and energy expenditure were obtained by indirect calorimetry. The affinity of oxygenated hemoglobin was determined by a blood oxygen dissociation analyzer.
An increased hemoglobin level resulted in a suppression of erythropoietin secretion (p < 0.001), whereas heart rate, cardiac output, stroke volume, and SF decreased (p < 0.05). Weight gain before and after transfusion were similar. Plasma lactate levels decreased from 1.6 +/- 0.3 to 1.2 +/- 0.3. Oxygen consumption, carbon dioxide production, and energy expenditure were not affected.
Anemia of prematurity and BPD increase heart rate, cardiac output, stroke volume, and SF. These hemodynamic compensatory responses are normalized by transfusion.
测定输血前后早产贫血在支气管肺发育不良（BPD）期间以及对代谢和红细胞生成功能的影响。对14名贫血（血红蛋白范围：65 - 88克/升）、依赖氧气（吸入氧分数≤35%）、未通气的BPD早产儿在出生后6±2周进行研究。
通过脉冲和连续波多普勒超声心动图评估心输出量、心率、圆周纤维缩短平均速度、缩短分数（SF）和每搏输出量。通过间接量热法获得静息耗氧量、二氧化碳产生量和能量消耗值。用血液氧解离分析仪测定氧合血红蛋白的亲和力。
血红蛋白水平升高导致促红细胞生成素分泌受抑制（p < 0.001），而心率、心输出量、每搏输出量和SF降低（p < 0.05）。输血前后体重增加相似。血浆乳酸水平从1.6±0.3降至1.2±0.3。耗氧量、二氧化碳产生量和能量消耗未受影响。
早产贫血和BPD会增加心率、心输出量、每搏输出量和SF。这些血流动力学代偿反应通过输血得以正常化。
