Abstract
BackgroundAdverse 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.MethodsA 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.DiscussionThis 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.Trial RegistrationPROSPERO, CRD42013005107http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013005107
Highlights
Adverse transfusion reactions in the neonatal population are poorly understood and defined
* Correspondence: amy.keir@adelaide.edu.au 1School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5005, Australia 2Department of Neonatal Medicine, Level 1 Queen Victoria Building, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia Full list of author information is available at the end of the article to manage Anaemia of prematurity (AOP) with over 90% of preterm neonates with a birthweight at
The need for standardised neonatal definitions for all relevant adverse effects is likely to be highlighted by this review, as well as the need for consistent reporting
Summary
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 carry out meta-analyses on the listed outcomes
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