title: Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion.
abstract: OBJECTIVE
  Preterm infants are frequently transfused with red blood cells based on standardized guidelines or clinical concerns that anemia taxes infants' physiological compensatory mechanisms and thereby threatens their health and well-being. The impact of various transfusion guidelines on long-term neurocognitive outcome is not known. The purpose of this study is to evaluate long-term neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines.
  
  
  METHODS
  Neurocognitive outcomes were examined at school age for 56 preterm infants randomly assigned to a liberal (n = 33) or restrictive (n = 23) transfusion strategy. Tests of intelligence, achievement, language, visual-spatial/motor, and memory skills were administered. Between-group differences were assessed.
  
  
  RESULTS
  Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency, visual memory, and reading.
  
  
  CONCLUSIONS
  Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels.
authors.affiliation: Department of Pediatrics, University of Iowa, Iowa City, IA 52245, USA. mccoyt@healthcare.uiowa.edu
authors.forename: Thomasin E
authors.initials: TE
authors.lastname: McCoy
authors.forename: Amy L
authors.initials: AL
authors.lastname: Conrad
authors.forename: Lynn C
authors.initials: LC
authors.lastname: Richman
authors.forename: Scott D
authors.initials: SD
authors.lastname: Lindgren
authors.forename: Peg C
authors.initials: PC
authors.lastname: Nopoulos
authors.forename: Edward F
authors.initials: EF
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002657:Child Development; D003071:Cognition; D004522:Educational Status; D017707:Erythrocyte Transfusion / Q000523:psychology; D005260:Female; D006400:Hematocrit / Q000523:psychology / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D017410:Practice Guidelines as Topic; D011597:Psychomotor Performance; D014888:Wechsler Scales