Are regular 'top-up' transfusions necessary in otherwise well, growing premature infants?

To test the hypothesis that very low-birth-weight neonates who are otherwise well and are growing, are not compromised if their haemoglobin concentration is allowed to fall below 10 g/dl, 20 such neonates were randomly divided into two groups. The infants in one group received 'top-up' transfusions to keep their haemoglobin concentrations above 10 g/dl, while haemoglobin concentrations in the other group were allowed to fall below this level. Although the group which did not receive transfusions had significantly lower haemoglobin values, no significant differences in clinical well-being and daily mass gain were observed. The non-transfused group also had significantly higher reticulocyte counts. We conclude that it is not necessary to administer routine top-up transfusions to these infants.