Journal
JOURNAL OF PEDIATRICS
Volume 155, Issue 3, Pages 331-337Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2009.02.026
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Funding
- University of Washington Department of pediatrics Academic Enrichment Fund [1 UL1 RR025014-01]
- National Center for Research Resources
- National Institutes of Health
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR000423] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR025014] Funding Source: NIH RePORTER
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Objectives To determine the risks and benefits associated with the transfusion of packed red blood cells (PRBCs) in extremely low birth weight (ELBW) infants. We hypothesized that when ELBW infants underwent transfusion with the University of Washington Neonatal Intensive Care Unit (NICU) 2006 guidelines, no clinical benefit would be discernible. Study design We conducted a retrospective chart review of all ELBW infants admitted to the NICU in 2006. Information on weight gain, apnea, heart rate, and respiratory support was collected for 2 days preceding, the day of, and 3 days after PRBC transfusion. The incidence, timing, and severity of complications of prematurity were documented. Results Of the 60 ELBW infants admitted to the NICU in 2006, 78% received PRBC transfusions. Transfusions were not associated with improved weight gain, apnea, or ventilatory/oxygen needs. However, they were associated with increased risk of bronchopulmonary dysplasia, necrotizing enterocolitis, and diuretic use (P <.05). Transfusions correlated with phlebotomy losses, gestational age, and birth weight. No association was found between transfusions and sepsis, retinopathy of prematurity, or erythropoietin use. Conclusions When our 2006 PRBC transfusion guidelines were used, no identifiable clinical benefits were identified, but increased complications of prematurity were noted. New, more restrictive guidelines were developed as a result of this study. (J Pediatr 2009; 155:331-7).
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