4.1 Article

Neurocognitive profiles of preterm infants randomly assigned to lower or higher hematocrit thresholds for transfusion

Journal

CHILD NEUROPSYCHOLOGY
Volume 17, Issue 4, Pages 347-367

Publisher

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/09297049.2010.544647

Keywords

Preterm; Neuropsychology; Red blood cell transfusion; Hematocrit; Longitudinal

Funding

  1. National Center for Research Resources (NCRR), a part of the National Institutes of Health (NIH) [UL1RR024979]
  2. PPG (NIH) [P01 HL046925]
  3. ICTS/CTSA CRU
  4. NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR024979] Funding Source: NIH RePORTER
  5. NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [P01HL046925] Funding Source: NIH RePORTER

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Objective: Preterm infants are frequently transfused with red blood cells based on standardized guidelines or clinical concerns that anemia taxes infants' physiological compensatory mechanisms and thereby threatens their health and well-being. The impact of various transfusion guidelines on long-term neurocognitive outcome is not known. The purpose of this study is to evaluate long-term neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines. Methods: Neurocognitive outcomes were examined at school age for 56 preterm infants randomly assigned to a liberal (n=33) or restrictive (n=23) transfusion strategy. Tests of intelligence, achievement, language, visual-spatial/motor, and memory skills were administered. Between-group differences were assessed. Results: Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency, visual memory, and reading. Conclusions: Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels.

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