title: Changes in neonatal transfusion practice after dissemination of neonatal recommendations.
abstract: OBJECTIVE
  To evaluate the change in neonatal transfusion practices after the introduction of national recommendations for transfusion of blood products to neonates in 2006.
  
  
  METHODS
  A questionnaire-based survey on neonatal transfusion practice of 79 Italian NICUs was completed in 2008. Results were compared with those obtained from a previous national Italian neonatal transfusion-practice survey performed in 2001.
  
  
  RESULTS
  Responses were received from 62 of 79 (78.5%) neonatal units. Prophylaxis for transfusion-transmitted cytomegalovirus infection in 2001 and 2008 had been performed in 96.8% and 98.4% of NICUs, respectively. Filter leukoreduction of red blood cell donor units was preferred over cytomegalovirus antibody testing to obtain cytomegalovirus-safe blood components. Prophylaxis for graft-versus-host disease increased from being performed at 61.3% of neonatal units in 2001 to 77.4% in 2008 (P = .08, Pearson chi(2)), whereas usage of dedicated red blood cell donor units (paedipack system), permitting multiple transfusions from the same unit, improved from 53.2% to 82.2% (P = .001, Pearson chi(2)). The 2008 survey documented a continuation of wide variability in transfusion practice for fresh-frozen plasma and platelet concentrates.
  
  
  CONCLUSIONS
  This nation-wide Italian self-report survey highlighted improvements in NICU transfusion practice after the neonatal recommendations issued in 2006. Prophylaxis for transfusion-transmitted cytomegalovirus infection continued with nearly total adherence to national recommendations, and both prophylaxis for graft-versus-host disease and paedipack-system usage suggested a trend of improvement of adherence rates. The continuing wide diversity observed among neonatal units in fresh-frozen plasma and platelet-concentrate transfusion practice may indicate a lack of acceptable criteria for the administration of these blood products.
authors.affiliation: Neonatology and Neonatal Intensive Care, Children's Hospital of Brescia, Pzz. le Spedali Civili, 25123 Brescia, Italy. lvmott@tin.it
authors.forename: Mario
authors.initials: M
authors.lastname: Motta
authors.forename: Marcella
authors.initials: M
authors.lastname: Testa
authors.forename: Gino
authors.initials: G
authors.lastname: Tripodi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Radicioni
mesh_terms: D000367:Age Factors; D001803:Blood Transfusion / Q000379:methods* / Q000592:standards*; D003625:Data Collection; D006287:Health Planning Guidelines; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*