Neonatal transfusion practice

Murray, Neil A; Roberts, Irene

doi:10.1136/adc.2002.019760

Cited by 84 publications

(39 citation statements)

References 76 publications

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“…The guidelines for transfusion of PRBC vary according to age, level of sickness and hematocrit (Table 1). 3 …”

Section: Indications For Prbc Transfusion In Neonatal Practicementioning

confidence: 97%

“…3 It has not been shown to have any survival benefits in most of these conditions and currently the only valid indications for transfusing FFP in a newborn include • Disseminated intravascular coagulopathy • Vitamin K deficiency bleeding • Inherited deficiencies of coagulation factors Other rare indications include patients with afibrinogenemia, von Willebrand factor deficiency, congenital antithrombin III deficiency, protein C deficiency and protein S deficiency when specific factor replacement is not available. It is also used for reconstitution of blood for exchange transfusion.…”

Section: Fresh Frozen Plasmamentioning

confidence: 98%

“…3 Indications for transfusion of PRBCs are mainly for resolution of symptomatic anemia and improvement of tissue oxygenation. Tissue oxygenation depends on cardiac output, oxygen saturation and hemoglobin concentration.…”

Section: Indications For Prbc Transfusion In Neonatal Practicementioning

confidence: 99%

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Blood and blood component therapy in neonates

et al. 2008

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Blood component therapy is a very common intervention practiced in newborns; nearly 85% of extremely low birth weight (ELBW) babies get transfusions during their hospital stay. However, there are no set guidelines for transfusion of blood component therapy in newborns. This protocol includes available types of blood components, their methods of preparation, indications and side effects of transfusion, in relation to newborns.

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“…The guidelines for transfusion of PRBC vary according to age, level of sickness and hematocrit (Table 1). 3 …”

Section: Indications For Prbc Transfusion In Neonatal Practicementioning

confidence: 97%

Section: Fresh Frozen Plasmamentioning

confidence: 98%

See 1 more Smart Citation

Blood and blood component therapy in neonates

et al. 2008

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“…Although a transfusion volume of 10 ml/kg is currently standard of care [8], the optimal volume used for transfusion of platelets in the newborn has not been definitively established [9]. In this study our primary objective was to determine changes in thrombopoietin (Tpo) following transfusion of platelets in preterm neonates.…”

Section: Introductionmentioning

confidence: 99%

Thrombopoietin following transfusion of platelets in preterm neonates

et al. 2008

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Thrombocytopenia is common in the neonatal intensive care unit. Transfusion of platelets is often required. The purpose of our study was to determine changes in thrombopoietin (Tpo) following transfusion of platelets in preterm neonates. Preterm neonates undergoing platelet transfusion were randomized to receive a transfusion volume of either 10 or 15 ml/kg. Blood was obtained for Tpo measurement pre-transfusion, one and 24 hours post-transfusion. Platelet Factor 4 (PF4) was also measured to quantify platelet activation. Statistical analysis was performed using repeated measures ANOVA, and Mann-Whitney U test as appropriate. Ten infants were enrolled in each group. Gestational age, birth weight, etiology of thrombocytopenia, and timing of transfusion did not differ between the 10 and 15 ml/kg groups. There were no differences between the groups in platelet count prior to and/or following transfusion. Both transfusion volumes were equally well tolerated. Tpo and PF4 did not differ between groups at any of the study time points. When both groups were analysed together, Tpo dropped 43% (95% confidence 37-49%, p = 0.01) 1-hour post compared to pre-transfusion. In conclusion the observed decrease in Tpo following platelet transfusion suggests that Tpo kinetics in neonates is similar to adults following transfusion. PF4 was not affected by transfusion. There was not an increase in platelet count following transfusion volume of 15 ml/kg compared to 10 ml/kg.

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“…This paper reviews the existing criteria for initiating ET in late-preterm and term infants with SNH and how these can be optimized to provide timely (while avoiding unnecessary) ET in resource-poor countries. It excludes discussions regarding the technique, resources, and provider expertise for the procedure as these are well described in the literature [5,14]. …”

Section: Introductionmentioning

confidence: 99%

Revisiting the Criteria for Exchange Transfusion for Severe Neonatal Hyperbilirubinemia in Resource-Limited Settings

et al. 2015

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Background: Exchange transfusion (ET) for severe neonatal hyperbilirubinemia (SNH) is frequently undertaken in low- and middle-income countries (LMIC), in sharp contrast to the prevailing practice in high-income countries. However, the criteria for initiating this procedure in settings with limited resources for treating infants with SNH have not been systematically explored. Objective: To identify key considerations for initiating ET in resource-poor countries to curtail its unnecessary use for the prevention of kernicterus. Methods: A review of the existing guidelines and literature on the management of neonatal hyperbilirubinemia worldwide was conducted to identify criteria and underlying factors for initiating ET. Results: There is a dearth of evidence from randomized clinical trials to support clear criteria for indicated ET worldwide. Because risk assessment for kernicterus based solely on the levels of total serum bilirubin (TSB) has often proved inadequate, a combination of plasma/serum bilirubin estimation and clinical evaluation for acute bilirubin encephalopathy (ABE) has been recommended for predicting the risk of kernicterus. However, there is a lack of consistency regarding the TSB levels for which ET should be initiated in relation to the clinical signs/symptoms of ABE and hemolytic disorders. Conclusions: A decision-making framework that combines TSB thresholds and evidence of neurotoxicity is needed for evaluating the risk of kernicterus and prioritising infants for ET in LMICs to curtail unnecessary interventions.

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Neonatal transfusion practice

Cited by 84 publications

References 76 publications

Blood and blood component therapy in neonates

Blood and blood component therapy in neonates

Thrombopoietin following transfusion of platelets in preterm neonates

Revisiting the Criteria for Exchange Transfusion for Severe Neonatal Hyperbilirubinemia in Resource-Limited Settings

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