Erythrocyte concentrates are preferred increasingly to whole-blood transfusions in treatment of neonatal anemias. By means of their application even very important restorations of hematocrit are possible without the risk of fluid overload. A possible side-effect of these erythrocyte suspensions is a transfusion mediated acidosis, which depends on the used buffer solution, temperature and storage conditions before and during use. The case report of a preterm infant with Rh-Erythroblastosis and postpartal shock demonstrates the problem of an additional acidosis caused by the ACD-adenin stabilised erythrocyte concentrate. The impression of a transfusion mediated acidaemia is confirmed by 30 comparative pH-measurements in ACD-adenin and heparin stored erythrocytes. We conclude that erythrocyte transfusions in very ill neonates with severe disturbances of metabolism and reduced organ functions should be done with heparin erythrocyte preparations.
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