Strict red blood cell transfusion guideline reduces the need for transfusions in very-low-birthweight infants in the first 4 weeks of life: a multicentre trial

• Published in: Vox sanguinis Vol. 88; no. 2; pp. 107 - 113
• Main Authors: Miyashiro, A. M., Dos Santos, N., Guinsburg, R., Kopelman, B. I., De Araújo Peres, C., De Lima Taga, M. F., Shinzato, A. R., De Paula Fiod Costa, H.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.02.2005; S. Karger AG
• Subjects: anaemia; Babies; blood transfusion; Blood transfusions; Blood Volume; Cohort Studies; Erythrocyte Transfusion - utilization; Erythrocytes; Gestational Age; Guidelines; Hematocrit; Hemoglobins - analysis; Hospitalization; Humans; Infant, Newborn; Infant, Very Low Birth Weight - blood; newborn infant; Practice Guidelines as Topic; Premature Birth - blood; premature infant
• ISSN: 0042-9007; 1423-0410
• DOI: 10.1111/j.1423-0410.2005.00607.x

Background and Objectives  Very‐low‐birthweight infants are among the most heavily transfused patients. The objective of this study was to verify if the introduction of a strict guideline would reduce the need for red blood cell transfusions in the first 4 weeks of life in these neonates. Materials and Methods  This was a multicentre prospective study of two cohorts of very‐low‐birthweight infants transfused in accordance with the recommendations of a neonatologist (Phase 1) or according to previously published guidelines (Phase 2). Results  In the first 28 days of life, 102 patients (68·5%) in Phase 1 and 117 (59·7%) in Phase 2 were transfused. The number of transfusions was 1·9 ± 2·0 in Phase 1 and 1·4 ± 1·6 in Phase 2 (P = 0·01). After adjusting for gestational age, blood loss and the presence of respiratory distress syndrome, the strict guideline reduced the number of transfusions in 17·6% (IC 95%−30·5% to −2·6%). Conclusions  The strict guideline was effective in reducing erythrocyte transfusions in very‐low‐birthweight infants.