A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Transfusion practices in 12 Neonatal Networks – Are we closer to adopting a restrictive transfusion approach?
Tekijät: Klinger, Gil; Helenius, Kjell; Vento, Maximo; Kusuda, Satoshi; Norman, Mikael; Procianoy, Renato Soibelman; Goswami, Neha; Biran, Valerie; Bassler, Dirk; Reichman, Brian; Skubisz, Aleksandra; Battin, Malcolm; Lehtonen, Liisa; Lui, Kei; Mori, Annalisa; Beltempo, Marc; Adams, Mark; San Feliciano, Laura; Isayama, Tetsuya; Shah, Prakesh S.; iNeo Investigators
Kustantaja: S. Karger AG
Kustannuspaikka: BASEL
Julkaisuvuosi: 2025
Journal: Neonatology
Tietokannassa oleva lehden nimi: Neonatology
Lehden akronyymi: NEONATOLOGY
Sivujen määrä: 9
ISSN: 1661-7800
eISSN: 1661-7819
DOI: https://doi.org/10.1159/000546612
Verkko-osoite: https://doi.org/10.1159/000546612
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/499389583
Introduction: Recent evidence suggests a restrictive approach toward blood transfusions for management of preterm infants. Objective was to survey blood transfusion practises in preterm neonates <29 weeks' gestation among 12 population-based neonatal networks participating in the International Network for Evaluating Outcomes in Neonates (iNeo).
Methods: An online survey based on 2023 practices was sent to 608 neonatal intensive care units (NICUs): Australia/New Zealand (30), Brazil (20), Canada (32), Finland (5), France (70), Israel (26), Japan (292), Poland (56), Spain (55), Sweden (9), Switzerland (9), and Tuscany, Italy (4). Transfusion thresholds in 4 different scenarios were surveyed: (a) infants invasively ventilated within first 7 postnatal days, (b) infants invasively ventilated after 7 days, (c) stable infants on noninvasive respiratory support, and (d) stable infants requiring no respiratory support.
Results: A total of 382 NICUs (63%) responded. Transfusion practices varied within networks and between countries. For invasively ventilated infants, the transfusion threshold during first 7 days after birth was a hematocrit ≤35% in 79% of NICUs, and at an age ≥8 days, the transfusion threshold was a hematocrit ≤30% in 68% of NICUs. For stable infants on noninvasive ventilation, the transfusion threshold was a hematocrit ≤30% in 80%, and in those without respiratory support, the transfusion threshold was a hematocrit of ≤25% in 68% of NICUs.
Conclusions: Variations exist in blood transfusion practises between countries and within networks. A restrictive transfusion approach based on recent recommendations has been adopted by more than two-thirds of NICUs. Additional research is needed to evaluate whether practices align with intentions and how they impact outcomes.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
Julkaisussa olevat rahoitustiedot:
The International Network for Evaluating Outcomes of Neonates (iNeo) has been supported by the Canadian Institutes of Health Research [APR-126340 and PBN 150642 to P.S.S.]. The Australian and New Zealand Neonatal Network is predominantly funded by membership contributions from the participating centers. The Canadian Neonatal Network is supported by a team grant from the Canadian Institutes of Health Research [CTP 87518] and by the participating centers. The Finnish Medical Birth Register is governmentally funded and kept by the National Institute for Health and Welfare (THL). The Israel Neonatal Network very low birth weight infant database is partially funded by the Israel Center for Disease Control and the Ministry of Health. The Neonatal Research Network of Japan is partly funded by a Health Labour Sciences Research Grant from the Ministry of Health, Labour and Welfare of Japan. The Spanish Neonatal Network is supported by funds from the Spanish Neonatal Society (SENeo). The Swedish Neonatal Quality Register is funded by the Swedish Government (Ministry of Health and Social Affairs), the Swedish Association of Local Communities and Regions (SALAR), and the participating units. The Swiss Neonatal Network is partially funded by the participating units in the form of membership fees. This research was also supported by Instituto de Investigacion Sanitaria Carlos III (Ministry of Science, Innovation and Universities, Kingdom of Spain) [FIS17/0131 to M.V.]; and RETICS funded by the PN 2018-2021 (Spain), ISCIII-Sub-Direct orate General for Research Assessment and Promotion, and the European Regional Development Fund (ERDF) [RD 16/0022]; and by grants from a regional agreement on clinical research (ALF) between Region Stockholm and Karolinska Institutet [2020-0443 to M.N.]. The funding body played no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
