Cord blood sampling in preventing anemia in extremely preterm infants

Abstract

Although appreciating the findings of the study regarding the use of cord blood sampling in preventing anemia in extremely preterm infants, the authors omitted to emphasize that routine search for coagulation and polymerase chain reaction test abnormalities during the first hours of life is of limited value, providing unreliable results for patient management and potentially unnecessary blood loss. 1-3 We suggest that a possible bias in the difference in transfusion rate between the 2 studies could be due to the relevant amount of blood sampled from venous access in the control group. Assuming that the blood volume in extremely preterm infants is about 80 mL/kg, drawing about 5 mL from each patient would mean a blood loss of about 8% of the circulating volume that could be critical in this delicate setting. Furthermore, although cord blood sampling could be the right direction for preventing anemia in extremely preterm infants, cord blood it is not always available. We suggest that avoidance of sampling for unreliable tests and widespread implementation of point-of-care analyzer with micro-methods technology for blood count, electrolytes, and blood gas could be an adjunctive and even more efficient approach for limiting blood losses in this specific population.