Effects of transfusions in extremely low birth weight infants: a retrospective study.
OBJECTIVE
To determine the risks and benefits associated with the transfusion of packed red blood cells (PRBCs) in extremely low birth weight (ELBW) infants. We hypothesized that when ELBW infants underwent transfusion with the University of Washington Neonatal Intensive Care Unit (NICU) 2006 guidelines, no clinical benefit would be discernible.


METHODS
We conducted a retrospective chart review of all ELBW infants admitted to the NICU in 2006. Information on weight gain, apnea, heart rate, and respiratory support was collected for 2 days preceding, the day of, and 3 days after PRBC transfusion. The incidence, timing, and severity of complications of prematurity were documented.


RESULTS
Of the 60 ELBW infants admitted to the NICU in 2006, 78% received PRBC transfusions. Transfusions were not associated with improved weight gain, apnea, or ventilatory/oxygen needs. However, they were associated with increased risk of bronchopulmonary dysplasia, necrotizing enterocolitis, and diuretic use (P < .05). Transfusions correlated with phlebotomy losses, gestational age, and birth weight. No association was found between transfusions and sepsis, retinopathy of prematurity, or erythropoietin use.


CONCLUSIONS
When our 2006 PRBC transfusion guidelines were used, no identifiable clinical benefits were identified, but increased complications of prematurity were noted. New, more restrictive guidelines were developed as a result of this study.
Valieva
Olga A
OA
Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA 98195-6320, USA.
Strandjord
Thomas P
TP
Mayock
Dennis E
DE
Juul
Sandra E
SE
D000046:Academic Medical Centers / Q000379:methods; D000751:Anemia, Neonatal / Q000628:therapy*; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome