title: 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.
abstract: 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.
authors.affiliation: Department of Pediatrics, Division of Neonatal Medicine, Federal University of São Paulo, São Paulo, Brazil. ameliamiyashiro@yahoo.com.br
authors.forename: A M
authors.initials: AM
authors.lastname: Miyashiro
authors.forename: N dos
authors.initials: Nd
authors.lastname: Santos
authors.forename: R
authors.initials: R
authors.lastname: Guinsburg
authors.forename: B I
authors.initials: BI
authors.lastname: Kopelman
authors.forename: C de Araújo
authors.initials: Cde A
authors.lastname: Peres
authors.forename: M F de Lima
authors.initials: MF
authors.lastname: Taga
authors.forename: A R
authors.initials: AR
authors.lastname: Shinzato
authors.forename: H de Paula Fiod
authors.initials: Hde P
authors.lastname: Costa
mesh_terms: 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
chemical_list: D006454:Hemoglobins