Effects of Transfusions in Extremely Low Birth Weight Infants: A Retrospective Study - 09/08/11
Reprint requests: Sandra Juul, MD, PhD, Department of Pediatrics, Division of Neonatology, University of Washington, Box 356320, Seattle, WA 98195-6320.Abstract |
Objectives |
To determine the risks and benefits associated with the transfusion of packed red blood cells (PRBCs) in extremely low birth weight (ELBW) infants. We hypothesized that when ELBW infants underwent transfusion with the University of Washington Neonatal Intensive Care Unit (NICU) 2006 guidelines, no clinical benefit would be discernible.
Study design |
We conducted a retrospective chart review of all ELBW infants admitted to the NICU in 2006. Information on weight gain, apnea, heart rate, and respiratory support was collected for 2 days preceding, the day of, and 3 days after PRBC transfusion. The incidence, timing, and severity of complications of prematurity were documented.
Results |
Of the 60 ELBW infants admitted to the NICU in 2006, 78% received PRBC transfusions. Transfusions were not associated with improved weight gain, apnea, or ventilatory/oxygen needs. However, they were associated with increased risk of bronchopulmonary dysplasia, necrotizing enterocolitis, and diuretic use (P < .05). Transfusions correlated with phlebotomy losses, gestational age, and birth weight. No association was found between transfusions and sepsis, retinopathy of prematurity, or erythropoietin use.
Conclusions |
When our 2006 PRBC transfusion guidelines were used, no identifiable clinical benefits were identified, but increased complications of prematurity were noted. New, more restrictive guidelines were developed as a result of this study.
Le texte complet de cet article est disponible en PDF.Mots-clés : BPD, BW, CPAP, DOL, ELBW, Epo/rEpo, GA, HCT, IVH, NEC, NICU, NS, PRBC, ROP, UWMC
Plan
| This study was made possible by a grant from the University of Washington Department of Pediatrics Academic Enrichment Fund and a grant (number 1 UL1 RR025014-01) from the National Center for Research Resources, a component of the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources or National Institutes of Health. The authors declare no conflicts of interest. |
Vol 155 - N° 3
P. 331 - septembre 2009 Retour au numéro
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