低血红蛋白度与高血红蛋白度的临界值用于输血,以预防出生体重非常低的婴儿的发病率和死亡率
Chad Andersen1,2, Michael J Stark1,2, Tara Crawford1
1Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
The Cochrane database of systematic reviews
|December 11, 2025
概括
对于出生时体重非常低的婴儿,限制性红细胞输血门与自由门相比,死亡或神经发育结果几乎没有差异. 限制性策略可能会减少在住院期间的输血暴露.
科学领域:
- 新生儿医学 新生儿医学
- 儿科血液学 儿科血液学
- 临床试验方法论 临床试验方法论
背景情况:
- 出生时体重非常低的婴儿通常需要输血红细胞.
- 输血决定通常以血红蛋白/血红素值或临床状况为指导.
- 有关慢性贫血对神经发育和输血风险的影响存在担忧.
研究的目的:
- 为了比较限制性与自由的血红蛋白值对于红细胞输血在出生时体重非常低的婴儿.
- 评估对死亡率,神经发育结果和输血频率的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 2024年1月在多个数据库中进行的搜索.
- 主要结局包括死亡或神经发育障碍,全因死亡率和输血次数.
主要成果:
- 分析了6项涉及3451名婴儿的RCT.
- 限制性与自由的门在死亡或神经发育障碍 (高确定性证据) 中几乎没有差异.
- 限制性门导致每名婴儿的输血减少 (低确定性证据).
结论:
- 使用限制性或自由血红蛋白值的输血策略对主要结果的影响最小.
- 限制性门导致输血暴露的适度减少.
- 低于测试限制值的血红蛋白水平的安全性需要在RCT中进一步评估.
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