Author Of 1 Presentation
RESTRICTIVE VERSUS LIBERAL RED BLOOD CELL TRANSFUSION IN BABIES LESS THAN 36 WEEKS GESTATIONS- A TALE OF TWO EPOCHS.
Abstract
Background
Anemia is a common issue faced by preterm infants <1500g. However, there is no consensus as to the threshold which RBCT should be given – divided into liberal versus restrictive thresholds. RBCT has been associated with many diseases of prematurity, including Necrotizing Enterocolitis (NEC), Intraventricular Haemorrhage (IVH) and Bronchopulmonary dysplasia (BPD).
Objectives
In keeping with current international practice1, our level III NICU in 2018 adopted more restrictive thresholds to transfuse premature babies. We audited this change to study any potential adverse impacts on morbidity and mortality.
Methods
We retrospectively reviewed the number of babies <36 weeks who were transfused at of the two time periods- 2016 (liberal threshold n=286) versus 2018 (n=266 restrictive threshold).
Results
51 /286 babies born in 2016(17.8%) received blood transfusions,significantly greater than the number of babies (30/266) born in 2018 (11.2%) (p-value 0.03). There was a decrease in the mortality rate for the restrictive cohort (3.3% vs. 11.7%) (p=0.192) and also reassuringly, no adverse impacts on ( BPD, NEC, ROP, days of oxygen dependency, length of stay and sepsis).There was a decrease in the mortality rate for the restrictive (3.3%) compared to the liberal cohort (11.7%).
Conclusion
Our change in practice from a liberal to a more restrictive transfusion policy in preterm babies <36 weeks was safe and did not result in any adverse impacts on neonatal mortality or morbidity. This is in keeping emerging evidence that supports a positive association between number of transfusions a baby is exposed to and risk of adverse neonatal outcomes.
Presenter of 1 Presentation
RESTRICTIVE VERSUS LIBERAL RED BLOOD CELL TRANSFUSION IN BABIES LESS THAN 36 WEEKS GESTATIONS- A TALE OF TWO EPOCHS.
Abstract
Background
Anemia is a common issue faced by preterm infants <1500g. However, there is no consensus as to the threshold which RBCT should be given – divided into liberal versus restrictive thresholds. RBCT has been associated with many diseases of prematurity, including Necrotizing Enterocolitis (NEC), Intraventricular Haemorrhage (IVH) and Bronchopulmonary dysplasia (BPD).
Objectives
In keeping with current international practice1, our level III NICU in 2018 adopted more restrictive thresholds to transfuse premature babies. We audited this change to study any potential adverse impacts on morbidity and mortality.
Methods
We retrospectively reviewed the number of babies <36 weeks who were transfused at of the two time periods- 2016 (liberal threshold n=286) versus 2018 (n=266 restrictive threshold).
Results
51 /286 babies born in 2016(17.8%) received blood transfusions,significantly greater than the number of babies (30/266) born in 2018 (11.2%) (p-value 0.03). There was a decrease in the mortality rate for the restrictive cohort (3.3% vs. 11.7%) (p=0.192) and also reassuringly, no adverse impacts on ( BPD, NEC, ROP, days of oxygen dependency, length of stay and sepsis).There was a decrease in the mortality rate for the restrictive (3.3%) compared to the liberal cohort (11.7%).
Conclusion
Our change in practice from a liberal to a more restrictive transfusion policy in preterm babies <36 weeks was safe and did not result in any adverse impacts on neonatal mortality or morbidity. This is in keeping emerging evidence that supports a positive association between number of transfusions a baby is exposed to and risk of adverse neonatal outcomes.