Effect of blood transfusion on oxygen transport
Research type
Research Study
Full title
Changes in haemoglobin-oxygen affinity and oxygen delivery following red cell transfusions in critically ill children
IRAS ID
273915
Contact name
Samiran Ray
Contact email
Sponsor organisation
Great Ormond Street Hospital for Children
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
0 years, 4 months, 30 days
Research summary
It is common practice to administer blood transfusions to critically ill children in intensive care units. The intention is to increase the haemoglobin and improve oxygen carriage to cells around the body. However it is not known whether the transfusion of stored red blood cells in critical illness actually increases the release of oxygen to cells.
The aim of this study is to determine the change in oxygen delivery, haemoglobin-oxygen affinity which influences oxygen offloading following red blood cell transfusion.
The presence of a molecule called 2, 3 diphosphoglycerate (2,3DPG) reduces the affinity of haemoglobin (reflected in the p50) for oxygen and favours release of oxygen to tissues. Levels of 2,3DPG fall progressively the longer red cells are stored. This potentially reduces the release of oxygen from haemoglobin.
We will perform a prospective observational cohort study in children on intensive care units who receive blood transfusion as part of their standard care. We will compare oxygen delivery before and after blood transfusions. In order to assess haemoglobin-oxygen affinity we will also assess the p50 (using standard blood gas analysis based on the Sigaard-Andersen oxygen status algorithm) and 2,3DPG levels (using commercially available kits) before and after transfusion. The p50 is the partial pressure of oxygen which is required to saturate 50% of haemoglobin. A higher p50 indicates that a higher partial pressure of oxygen is needed to saturate haemoglobin. A lower value indicates that a lower partial pressure of oxygen is required to saturate haemoglobin.
REC name
London - Dulwich Research Ethics Committee
REC reference
20/LO/0166
Date of REC Opinion
27 Feb 2020
REC opinion
Favourable Opinion