Abstract
OBJECTIVE: In preterm newborn infants transfused with erythrocytes stored up to 28 days, to compare the reduction of blood donor exposure in two groups of infants classified according to birth weight. METHODS: A prospective study was conducted with preterm infants with birth weight <1000g (Group 1) and 1000-1499g (Group 2), born between April, 2008 and December, 2009. Neonates submitted to exchange transfusions, emergency erythrocyte transfusion, or those who died in the first 24 hours of life were excluded. Transfusions were indicated according to the local guideline using pediatric transfusion satellite bags. Demographic and clinical data, besides number of transfusions and donors were assessed. . Logistic regression analysis was performed to determine factors associated with multiple transfusions. RESULTS: 30 and 48 neonates were included in Groups 1 and 2, respectively. The percentage of newborns with more than one erythrocyte transfusion (90 versus 11%), the median number of transfusions (3 versus 1) and the median of blood donors (2 versus 1) were higher in Group 1 (p<0.001), compared to Group 2. Among those with multiple transfusions, 14 (82%) and one (50%) presented 50% reduction in the number of blood donors, respectively in Groups 1 and 2. Factors associated with multiple transfusions were: birth weight <1000g (OR 11.91; 95%CI 2.14-66.27) and presence of arterial umbilical catheter (OR 8.59; 95%CI 1.94-38.13), adjusted for confounders. CONCLUSIONS: The efficacy of pediatrics satellites bags on blood donor reduction was higher in preterm infants with birth weight <1000g.
Highlights
Preterm infants, especially those with birth weight less than 1500g, receive numerous red blood cell transfusions, and 65 to 87% of these patients undergo multiple transfusions[1].The use of restrictive transfusion guideline has reduced the number of transfusions over the years[1,2,3,4,5]
In Brazil, about 50% of newborns with birth weight less than 1500g receive more than one RBC transfusion during their hospital stay in the Neonatal Unit[5]
We identified the variables available in the first days of life to analyze factors associated with the need for multiple transfusions through logistic regression
Summary
Especially those with birth weight less than 1500g, receive numerous red blood cell transfusions, and 65 to 87% of these patients undergo multiple transfusions[1].The use of restrictive transfusion guideline has reduced the number of transfusions over the years[1,2,3,4,5]. In Brazil, about 50% of newborns with birth weight less than 1500g receive more than one RBC transfusion during their hospital stay in the Neonatal Unit[5]. In many institutions, such transfusions are performed with RBCs stored for up to 3–7 days. The 26 infants transfused with RBCs preserved for up to 28 days received 114 transfusions and were exposed to 34 blood donors. The 26 neonates who received RBC stored for up to 3 days received 109 transfusions and were exposed to 109 donors. Each neonate transfused with RBC preserved for up to 28 days was exposed, in average, to 1.5±0.8 donors (range: 1 to 4) and, in the traditional group, each neonate was exposed to 4.3±3.4 donors (range: 1 to 13), showing a 70.2% reduction in donor exposure
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