A survey of canadian neonatal blood transfusion practices

The premature infants in need of transfusion (pint) study: A randomized, controlled trial of a restrictive (LOW) versus liberal (HIGH) transfusion threshold for extremely low birth weight infants

“…1 These newborn infants rapidly become anemic from a combination of frequent laboratory blood sampling and an immature hematopoietic system, [2][3][4] leading to the transfusion of allogeneic red blood cells (RBCs) in at least 94%. 5 RBC transfusion guidelines available at the start of this trial 6,7 recommended the maintenance of the hemoglobin of ELBW infants at "physiologic" levels, but the justification for such an intervention is poorly supported. The risks and benefits of RBC transfusions to ELBW infants are unclear: Limiting RBC transfusions may reduce transfusion-associated infection and iron overload, but the resulting low hemoglobin levels may result in the morbidities associated with chronic anemic hypoxemia.…”

Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit

“…After correction for age and illness severity, the increased length of stay and complications shown in the children who received a transfusion provide supportive evidence that efforts at minimizing transfusions should continue. Most data available on incidence of anemia and transfusion practices in the children come from neonates, which do not provide clear guidance for the highly variable PICU population (18)(19)(20). Anemia in critically ill children is almost always treated by blood transfusion, and transfusions have been associated with increased PICU utilization (21).…”

Red Blood Cell Transfusion Is Not Associated with Necrotizing Enterocolitis: A Review of Consecutive Transfusions in a Tertiary Neonatal Intensive Care Unit

“…Between 50% and 94% of VLBW infants receive at least 1 transfusion during their hospital stay, due to frequent laboratory testing and immature hematopoietic systems. 15,28,30,31 An accurate assessment of the risks associated with pRBC transfusion is essential for clinical decision making in the neonatal intensive care unit (NICU). In addition to the well-known risks of blood products, such as infection or graft-vs-host disease, clinicians need to consider the potential risk of developing NEC from transfusions.…”