Journal article
Predictive Factors and Practice Trends in Red Blood Cell Transfusions for Very Low Birth Weight Infants
Pediatric research, Vol.79(5), pp.736-741
05/2016
DOI: 10.1038/pr.2016.4
PMCID: PMC4853266
PMID: 26756783
Abstract
Background: Red blood cell (RBC) transfusions in very-low-birth-weight (VLBW) infants, while common, carry risk. Our objective was to determine clinical predictors of and trends in RBC transfusions among VLBW infants.
Methods: RBC transfusion practice and its clinical predictors in 1,750 VLBW (≤1,500 g) infants were analyzed in a single-center cohort across sequential epochs: 2000-2004 (Epoch 1), 2005-2009 (Epoch 2), and 2010-2013 (Epoch 3).
Results: Overall, 1,168 (67%) infants received ≥1 transfusions. The adjusted likelihood of ≥1 transfusions decreased for each 1-g/dl increment in initial hemoglobin concentration following birth, for females, and for each 100-g increment in birth weight. The adjusted likelihood of ≥1 transfusions increased with infants receiving mechanical ventilation, with increasing length of hospital stay, necrotizing enterocolitis, and nonlethal congenital anomalies requiring surgery. The adjusted mean (SEM) number of transfusions per patient was decreased in Epoch 3, compared with Epoch 1 and Epoch 2. For an initial hemoglobin of ≥16.5 g/dl, the predicted probability of being transfused was ≤50%.
Conclusion: Adjusted RBC transfusions declined and female sex conferred an unexplained protection over the study period. Modest increases in initial hemoglobin by placentofetal transfusion at delivery may reduce the need for RBC transfusion.
Details
- Title: Subtitle
- Predictive Factors and Practice Trends in Red Blood Cell Transfusions for Very Low Birth Weight Infants
- Creators
- Osayame A Ekhaguere - Department of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania. USAFrank H Morriss - Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine and University of Iowa Children’s Hospital, University of Iowa. Iowa City, Iowa. USAEdward F Bell - Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine and University of Iowa Children’s Hospital, University of Iowa. Iowa City, Iowa. USANadkarni Prakash - Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine and University of Iowa Children’s Hospital, University of Iowa. Iowa City, Iowa. USAJohn A Widness - Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine and University of Iowa Children’s Hospital, University of Iowa. Iowa City, Iowa. USA
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.79(5), pp.736-741
- DOI
- 10.1038/pr.2016.4
- PMID
- 26756783
- PMCID
- PMC4853266
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Language
- English
- Date published
- 05/2016
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093371102771
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