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Variation in Neonatal Transfusion Practice.

Ravi M Patel1, Jeanne E Hendrickson2, Marianne E Nellis3

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The Journal of Pediatrics
|April 9, 2021
PubMed
Summary
This summary is machine-generated.

Neonatal transfusions vary widely in red blood cell, platelet, and plasma counts. Many transfusions exceed evidence-based thresholds, indicating a need for better patient blood management in neonates.

Keywords:
bloodinfantplasmaplateletpretermred blood cell

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Area of Science:

  • Neonatal Medicine
  • Hematology
  • Transfusion Medicine

Background:

  • Blood product transfusions are common in neonatal intensive care.
  • Variability exists in transfusion practices for neonates.
  • Evidence-based guidelines for neonatal transfusions are crucial.

Purpose of the Study:

  • To determine the incidence of red blood cell, platelet, and plasma transfusions in neonates.
  • To characterize pretransfusion hematologic values in infants during their initial hospitalization.
  • To assess adherence to evidence-based transfusion thresholds in neonates.

Main Methods:

  • Retrospective cohort study.
  • Data from 60,243 infants across 7 diverse US hospitals (2013-2016).
  • Pretransfusion hematologic values analyzed within 24 hours of transfusion.

Main Results:

  • Transfusion incidence varied significantly by gestational age (80% for <27 weeks vs. 0.5% for ≥37 weeks).
  • Median pretransfusion hemoglobin: 11.2 g/dL (entire cohort), 10.5 g/dL (<27 weeks), 13.0 g/dL (≥37 weeks).
  • Median pretransfusion platelet count: 71 x10^9/L; International Normalized Ratio: 1.7.

Conclusions:

  • Significant variability exists in pretransfusion hemoglobin, platelet, and INR values for neonatal transfusions.
  • A substantial proportion of neonatal transfusions may exceed evidence-based thresholds.
  • Opportunities exist to optimize patient blood management in neonatal care.