title: Adverse effects of small-volume red blood cell transfusions in the neonatal population.
abstract: BACKGROUND
  Adverse transfusion reactions in the neonatal population are poorly understood and defined. The incidence and pattern of adverse effects due to red blood cell (RBC) transfusion are not well known, and there has been no systematic review of published adverse events. RBC transfusions continue to be linked to the development of morbidities unique to neonates, including chronic lung disease, retinopathy of prematurity, intraventricular haemorrhage and necrotising enterocolitis. Uncertainties about the exact nature of risks alongside benefits of RBC transfusion may contribute to evidence of widespread variation in neonatal RBC transfusion practice.Our review aims to describe clinical adverse effects attributed to small-volume (10-20 mL/kg) RBC transfusions and, where possible, their incidence rates in the neonatal population through the systematic identification of all relevant studies.
  
  
  METHODS
  A comprehensive search of the following bibliographic databases will be performed: MEDLINE (PubMed/OVID which includes the Cochrane Library) and EMBASE (OVID). The intervention of interest is small-volume (10-20 mL/kg) RBC transfusions in the neonatal population.We will undertake a narrative synthesis of the evidence. If clinical similarity and data quantity and quality permit, we will also carry out meta-analyses on the listed outcomes.
  
  
  CONCLUSIONS
  This systematic review will identify and synthesise the reported adverse effects and associations of RBC transfusions in the neonatal population. We believe that this systematic review is timely and will make a valuable contribution to highlight an existing research gap.
  
  
  BACKGROUND
  PROSPERO, CRD42013005107http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005107.
authors.affiliation: School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5005, Australia. amy.keir@adelaide.edu.au.
authors.forename: Amy
authors.initials: A
authors.lastname: Keir
authors.forename: Sanchita
authors.initials: S
authors.lastname: Pal
authors.forename: Marialena
authors.initials: M
authors.lastname: Trivella
authors.forename: Lani
authors.initials: L
authors.lastname: Lieberman
authors.forename: Jeannie
authors.initials: J
authors.lastname: Callum
authors.forename: Nadine
authors.initials: N
authors.lastname: Shehata
authors.forename: Simon
authors.initials: S
authors.lastname: Stanworth
mesh_terms: D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D012107:Research Design; D065227:Transfusion Reaction / Q000453:epidemiology* / Q000209:etiology*