title: Does Red Blood Cell Transfusion-Related Acute Lung Injury Occur in Premature Infants? A Retrospective Cohort Analysis.
abstract: ObjectiveThe objective of this study was to determine whether packed red blood cell (pRBC) transfusions in extremely low birth weight (ELBW) infants were associated with acute respiratory decompensation (ARD).Study DesignRetrospective chart review of ELBW infant pRBC transfusions analyzed for meeting ARD criteria during the 6 hours post-pRBC transfusion was compared with the pretransfusion baseline period. A control period subdivided into similar pre- and postintervals was also assessed for each infant. ARD was defined as ≥ 1 of the following: (1) ≥ 10% increase in fraction of inspired oxygen from highest baseline, (2) ≥ 2 cm H2O increase from highest baseline in mean airway pressure, or (3) escalation in mode of respiratory support.ResultsA total of 238 pRBC transfusions occurred in 36 ELBW infants during 2012. Complete data for both the transfusion and control time periods existed for 110 pRBC transfusions (25 infants) and were included for analysis. The frequency of ARD was 15.5 and 18.2% (odds ratio, 1.25;p= 0.70) in the control and transfusion time periods, respectively.ConclusionpRBC transfusions in ELBW neonates are not associated with statistically significant rates of ARD compared with nontransfusion control time periods.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jacquelyn E M
authors.initials: JE
authors.lastname: Grev
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Charles University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Marketa
authors.initials: M
authors.lastname: Stanclova
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Ellsworth
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Colby
mesh_terms: D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D012189:Retrospective Studies; D000073617:Transfusion-Related Acute Lung Injury / Q000453:epidemiology* / Q000209:etiology