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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

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 https://orcid.org/0000-0002-8768-9263

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 https://orcid.org/0000-0003-3193-2559

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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