Blood Cell Transfusion In Neonates Research Articles

Peripherally inserted central catheter obstruction in packed red blood cell transfusions in neonates.

to estimate incidence and free time of peripherally inserted central catheter obstruction in newborns undergoing red blood cell transfusion in the first 24 hours after the procedure. a longitudinal study, carried out with neonates in Neonatal Intensive Care Unit at a teaching hospital in Paraná, between January and July 2019. The sample consisted of 46 transfusion events performed in neonates through a peripherally inserted central catheter. Analysis performed according to descriptive statistics. thirty-one catheters were analyzed, inserted in 24 neonates, through which 46 red blood cell transfusions were performed. Most neonates were male, gestational age <32 weeks, weight <1,500 grams, hospitalized mainly for prematurity. Among the 31 catheters, one (3.2%) presented obstruction after transfusion. The occurrence of obstructions immediately after transfusion was low and the catheters remained complication free for the next 24 hours.

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study.

BACKGROUNDLittle is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl−1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards.OBJECTIVETo observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome.DESIGNA multicentre observational study.SETTINGThe NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks’ postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017.PATIENTSThe data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion.MAIN OUTCOME MEASURESThe primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, ‘delta haemoglobin’ (preprocedure – transfusion-triggering) and 30-day and 90-day morbidity and mortality.RESULTSPeri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl−1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl−1 in week 2 and 8.0 [7.3 to 9.0] g dl−1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg−1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl−1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%.CONCLUSIONSResults indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies.TRIAL REGISTRATIONClinicalTrials.gov, identifier: NCT02350348

Cerebral Haemodynamic Changes by Red Blood Cell Transfusion in Neonates

Cerebral Haemodynamic Changes by Red Blood Cell Transfusion in Neonates

Approaches to understanding and interpreting the risks of red blood cell transfusion in neonates.

In this review, we explore how to assess potential harm related to neonatal transfusion practice. We consider different sources of information, including passive or active surveillance systems such as registries, observational studies, randomised trials and systematic reviews. Future research directions are discussed.

Factors affecting efficacy of packed red blood cell transfusion in neonates.

After 16mL/kg PRBC transfusion in neonates, haematocrit increased by 15% at 15min post transfusion. The equilibration in haematocrit values was achieved by 15min after transfusion. Baseline haematocrit of neonate, donor blood haematocrit and transfusion volume independently determine the rise in haematocrit. What is Known: • Rise in haematocrit following PRBC transfusion in neonates has been studied in a small number of stable infants. • Determinants of efficacy of PRBC transfusion have not been well studied in newborns. What is New: • Each milliliter/kilogramme of PRBC transfusion increases the neonate's haematocrit by approximately 1%. • Baseline haematocrit, donor blood haematocrit and transfusion volume per kilogramme body weight independently determine the rise in haematocrit.

Adverse effects of red blood cell transfusions in neonates: a systematic review and meta-analysis.

Controversy exists regarding the contribution of blood transfusions to a range of adverse clinical outcomes in neonates. The aim of our systematic review was to identify the broader literature on harmful effects and associations potentially attributable to red blood cell (RBC) transfusions. A comprehensive search of MEDLINE (PubMed) and EMBASE was undertaken. Eligible studies included both randomized controlled trials (RCTs) and nonrandomized studies examining the effects of small volume (10-20 mL/kg) RBC transfusions on neonates. Primary outcomes of interest were mortality, chronic lung disease, retinopathy of prematurity, necrotizing enterocolitis, and intraventricular hemorrhage. Two independent authors conducted a review of abstracts and then of full-text article reviews as well as data extraction and quality assessments. Sixty-one studies were eligible for inclusion, including 16 (26%) randomized studies. The majority of studies were nonrandomized (n = 45; 74%), which included 32 observational studies with and 13 studies without a comparator group. There was no evidence that rates of mortality differed between restrictive and liberal strategies for transfusion (eight RCTs: risk ratio, 1.24; 95% confidence interval, 0.89-1.672, heterogeneity = 0%) or for necrotizing enterocolitis (five RCTs: risk ratio, 1.45; 95% confidence interval, 0.91-2.33; heterogeneity = 0%). A liberal strategy also was not superior to restrictive transfusion practice in the pooled randomized studies for rates of retinopathy of prematurity, chronic lung disease, or intraventricular hemorrhage. Statistically significant differences in a range of harmful outcomes between neonates exposed to restrictive and liberal RBC transfusion practice were not found. However, the risks of bias identified in many studies and the lack of consistent reporting and definitions of events limits our conclusions.

Improving the management and outcome in haemolytic disease of the foetus and newborn.

Improving the management and outcome in haemolytic disease of the foetus and newborn.

Red Blood Cell Transfusion in Neonates

To the Editor.— Bell et al1 are to be congratulated for conducting and reporting their recent trial comparing the effects of restrictive and liberal thresholds for red blood cell transfusion in preterm neonates. Such patients receive large amounts of blood-component therapy, but despite considerable research in this patient group, virtually all blood-component therapy in preterm neonates remains opinion based rather than truly evidence based. Thus, any well-conducted research into the potential benefits and risks of blood components in preterm neonates must be welcomed with open arms. The critical …

Red Blood Cell Transfusion in Neonates: In Reply

Red Blood Cell Transfusion in Neonates: In Reply