Increased monocytes and bands following a red blood cell transfusion

Objective: The objective of this study is to analyze the white blood cell changes that occur after a transfusion of red blood cells in order to identify a subclinical inflammatory response in neonates. Study Design: Retrospective analysis of infants who received a red blood cell transfusion in an intensive care nursery. White blood cell results within 24 h pre- to 48 h post-transfusion were collected and analyzed. Statistical analysis included ANOVA, T -test, Mann–Whitney U test, Pearson's correlation and multivariable linear regression. Result: Monocytes ( P =0.02) and bands ( P =0.035) were increased post-transfusion. There were no differences in monocytes ( P =0.46) or bands ( P =0.56) between groups who did or did not have blood cultures obtained. There was no difference in monocytes between groups who did or did not have sepsis ( P =0.88). Conclusion: We identified an elevation in monocytes and bands in the 48 h following a transfusion in premature infants. Our findings support a possible pro-inflammatory response related to transfusion of red blood cells.