Red blood cell transfusions in preterm infants in 2021: a narrative review
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Abstract
Anemia is frequent in preterm infants. Red blood cell transfusion practices vary between different centers. The objective of this study was to review red blood cell transfusion practices in preterm infants between 2020 and 2021. This was a narrative review that included studies published on PubMed (Medline) and Web of Science between October 2020 and October 2021. Ten studies were included finally. Red blood cell transfusion frequency was variable. Some neonatal units did not report transfusion protocols. Most studies reported volumes of 10-15 ml/kg per transfusion. The implementation of an anemia care bundle and adoption of restrictive transfusion resulted in a reduction in the number of transfusions, the volume transfused, and a reduction in the rate of multiple transfusions. We suggest that neonatal units that care for preterm infants should have a transfusion protocol based on the best evidence available and this issue may improve.
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World Health Organization (WHO). Preterm birth. Available from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
Cibulskis CC, Maheshwari A, Rao R, Mathur AM. Anemia of prematurity: how low is too low? J Perinatol. 2021;41(6):1244-57. https://doi.org/10.1038/s41372-021-00992-0
Dallman PR. Anemia of prematurity. Ann Rev Med. 1981;32:143-60. https://doi.org/10.1146/annurev.me.32.020181.001043
Wang YC, Chan OW, Chiang MC, Yang PH, Chu SM, Hsu JF, et al. Red blood cell transfusion and clinical outcomes in extremely low birth weight preterm infants. Pediatr Neonatol. 2017;58(3):216-22. https://doi.org/10.1016/j.pedneo.2016.03.009
Dani C, Poggi C, Gozzini E, Leonardi V, Sereni A, Abbate R, et al. Red blood cell transfusions can induce proinflammatory cytokines in preterm infants. Transfusion. 2017;57(5):1304-10. https://doi.org/10.1111/trf.14080
Torres D, Silvera F, Borbonet D. TRALI neonatal. A propósito de un caso clínico. Arch Pediatr Urug. 2018;89(4):264-70. https://doi.org/10.31134/ap.89.4.6
Derienzo C, Smith PB, Tanaka D, Bandarenko N, Campbell ML, Herman A, et al. Feeding practices and other risk factors for developing transfusion-associated necrotizing enterocolitis. Early Hum Dev. 2014;90(5):237-40. https://doi.org/10.1016/j.earlhumdev.2014.02.003
Kirpalani H, Bell EF, Hintz SR, Tan S, Schmidt B, Chaudhary AS, et al. Higher or lower hemoglobin transfusion thresholds for preterm infants. N Engl J Med. 2020;383(27):2639-51. https://doi.org/10.1056/NEJMoa2020248
Howarth C, Banerjee J, Aladandady N. Red blood cell transfusion in preterm infants: current evidence and controversies. Neonatology. 2018;114(1):7-16. https://doi.org/10.1159/000486584
Fontana C, Raffaeli G, Pesenti N, Boggini T, Cortesi V, Manzoni F, et al. Red blood cell transfusions in preterm newborns and neurodevelopmental outcomes at 2 and 5 years of age. Blood Transfus. 2022;20(1):40-9. https://doi.org/10.2450/2020.0207-20
D’Amato G, Faienza MF, Palladino V, Bianchi FP, Natale MP, Christensen RD, et al. Red blood cell transfusions and potentially related morbidities in neonates under 32 weeks gestation. Blood Transfus. 2021;19(2):113-19. https://doi.org/10.2450/2020.0092-20
Rocha G, Pereira S, Antunes-Sarmento J, Flôr-de-Lima F, Soares H, Guimarães H. Early anemia and neonatal morbidity in extremely low birth-weight preterm infants. J Matern Fetal Neonatal Med. 2021;34(22):3697-703. https://doi.org/10.1080/14767058.2019.1689948
Balasubramanian H, Atyalgade M, Garg B, Srinivasan L, Kabra NS, Khapekar S. Effects of blood sampling stewardship and erythropoietin administration in extremely low birth weight infants-a quality improvement non-controlled before-and-after retrospective study. Eur J Pediatr. 2021;180(5):1617-26. https://doi.org/10.1007/s00431-020-03925-9
Alboalqez A, Deindl P, Ebenebe CU, Singer D, Blohm ME. Iatrogenic Blood Loss in Very Low Birthweight Infants and Transfusion of Packed Red Blood Cells in a Tertiary Care Neonatal Intensive Care Unit. Children (Basel). 2021;8(10):847. https://doi.org/10.3390/children8100847
Patel RM, Hendrickson JE, Nellis ME, Birch R, Goel R, Karam O, et al. Variation in neonatal transfusion practice. J Pediatr. 2021;235:92-99.e4. https://doi.org/10.1016/j.jpeds.2021.04.002
Vu PT, Ohls RK, Mayock DE, German KR, Comstock BA, Heagerty PJ, et al. Transfusions and neurodevelopmental outcomes in extremely low gestation neonates enrolled in the PENUT Trial: a randomized clinical trial. Pediatr Res. 2021;90(1):109-16. https://doi.org/10.1038/s41390-020-01273-w
Franz AR, Engel C, Bassler D, Rüdiger M, Thome UH, Maier RF, et al. Effects of liberal vs restrictive transfusion thresholds on survival and neurocognitive outcomes in extremely low-birth-weight infants: the ETTNO randomized clinical trial. JAMA. 2020;324(6):560-70. https://doi.org/10.1001/jama.2020.10690
Sahin S, Kutman HGK, Bozkurt O, Atay FY, Canpolat FE, Uras N, et al. Effect of withholding feeds on transfusion-related acute gut injury in preterm infants: a pilot randomized controlled trial. J Matern Fetal Neonatal Med. 2020;33(24):4139-44. https://doi.org/10.1080/14767058.2019.1597844
Schecer LV, Medina AE, Alexander JL, Sundararajan S. Impact of early postnatal exposure of red blood cell transfusions on the severity of retinopathy of prematurity. J Neonatal Perinatal Med. 2021;14(4):527-35. https://doi.org/10.3233/NPM-200679
Haghpanah S, Miladi S, Zamani A, Abadi AMKH, Gholami M, Gholami M. A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran. Cost Eff Resour Alloc. 2021;19(1):15. https://doi.org/10.1186/s12962-021-00267-7
Villeneuve A, Arsenault V, Lacroix J, Tucci M. Neonatal red blood cell transfusion. Vox Sang. 2021; 116(4):366-78. https://doi.org/10.1111/vox.13036
Uezima CL, Barreto AM, Guinsburg R, Chiba AK, Bordin JO, Barros MMO, et al. Reduction of exposure to blood donors in preterm infants submitted to red blood cell transfusions using pediatric satellite packs. Rev Paul Pediatr. 2013;31(3):285-92. https://doi.org/10.1590/S0103-05822013000300003