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.
OBJECTIVE
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.


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.
Miyashiro
A M
AM
Department of Pediatrics, Division of Neonatal Medicine, Federal University of São Paulo, São Paulo, Brazil. ameliamiyashiro@yahoo.com.br
Santos
N dos
Nd
Guinsburg
R
R
Kopelman
B I
BI
Peres
C de Araújo
Cde A
Taga
M F de Lima
MF
Shinzato
A R
AR
Costa
H de Paula Fiod
Hde P
D001810:Blood Volume; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005865:Gestational Age; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D017410:Practice Guidelines as Topic; D047928:Premature Birth / Q000097:blood
D006454:Hemoglobins