Exchange Transfusion in the Neonate with ACD or CPD Stored Blood

The blood of two groups of five neonates was exchanged to manage a hemolysis due to ABO incompatibility. Exchange transfusions were performed with ACD or CPD blood stored for less than 48 h. Blood oxygen affinity, hemoglobin, and 2,3-diphosphoglycerate concentrations, plasma and erythrolysate pH were measured on blood samples before and several times during the 24 h following the exchange. Infants transfused with CPD blood increased their P50 and 2,3-DPG concentration more rapidly than the group receiving ACD blood. Estimates of oxygen unloading capacities have been calculated, taking into account variations in hemoglobin concentration, P50, and pH. Assuming a constant cardiac output, transfusion with CPD blood might be more valuable than with ACD blood to insure oxygen transport, especially in infants with respiratory or cardiac impairments.