Issues in transfusing preterm infants in the NICU

Decisions regarding whether or not to transfuse preterm infants in the neonatal intensive care unit are often difficult. Although numbers of red blood cell transfusions have decreased in recent years, transfusions are still a common occurrence. For each infant, the advantages of transfusion must be balanced against the consequences and potential risks. This article examines physiologic and iatrogenic causes of anemia in preterm infants, clinical consequences of anemia, the use of transfusions and their risks, and the role of erythropoietin therapy.