Neonatal red blood cell transfusion

Villeneuve, Andréanne; Arsenault, Valérie; Lacroix, Jacques; Tucci, Marisa

doi:10.1111/vox.13036

Cited by 37 publications

(37 citation statements)

References 103 publications

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“…Although improvement in FTOEc is statistically significant, its biological significance is unknown. Substantial variability exists in NICU transfusion practices, with liberal vs. restriction transfusion guidelines [ 63 ]. These variations reflect the long-established controversies regarding neurological outcomes following restrictive versus liberal transfusion thresholds.…”

Section: Discussionmentioning

confidence: 99%

Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion

et al. 2022

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Background It is well established that counter-regulation to hypoxia follows a hierarchical pattern, with brain-sparing in preference to peripheral tissues. In contrast, it is unknown if the same hierarchical sequence applies to recovery from hypoxia after correction of anemia with packed red blood cell transfusion (PRBCT). Objective To understand the chronology of cerebral and splanchnic tissue oxygenation resulting after correction of anemia by PRBCT in preterm infants using near-infrared spectroscopy (NIRS). Design Prospective cohort study. Setting Neonatal intensive care. Patients included Haemodynamically stable infants: <32 weeks gestation, <37weeks postmenstrual age, <1500 grams birth weight; and ≥120 mL/kg/day feeds tolerated. Intervention PRBCT at 15 mL/Kg over 4 hours. Main outcome measures Transfusion-associated changes were determined by comparing the 4-hour mean pre-transfusion cerebral and splanchnic fractional tissue oxygen extraction (FTOEc0; FTOEs0) with hourly means during (FTOEc1-4; FTOEs1-4) and for 24 hours after PRBCT completion (FTOEc5-28; FTOEs5-28). Results Of 30 enrolled infants, 14[46.7%] male; median[IQR] birth weight, 923[655–1064]g; gestation, 26.4[25.5–28.1]weeks; enrolment weight, 1549[1113–1882]g; and postmenstrual age, 33.6[32.4–35]weeks, 1 infant was excluded because of corrupted NIRS data. FTOEc significantly decreased during and for 24 hours after PRBCT (p < 0.001), indicating prompt improvement in cerebral oxygenation. In contrast, FTOEs showed no significant changes during and after PRBCT (p>0.05), indicating failure of improvement in splanchnic oxygenation. Conclusion Improvement in regional oxygenation after PRBCT follows the same hierarchical pattern with a prompt improvement of cerebral but not splanchnic tissue oxygenation. We hypothesise that this hierarchical recovery may indicate continued splanchnic hypoxia in the immediate post-transfusion period and vulnerability to transfusion-associated necrotizing enterocolitis (TANEC). Our study provides a possible mechanistic underpinning for TANEC and warrants future randomised controlled studies to stratify its prevention.

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Section: Discussionmentioning

confidence: 99%

Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion

et al. 2022

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“…IDA and thalassemia syndromes are the two most common etiologies of microcytic hypochromic anemia in children and adults (Dolai et al, 2012;El-Agouza et al, 2002). While transfusions are more common in premature infants with approximately 40% of low birth weight infants and up to 90% of extremely low birth weight infants requiring red blood cell transfusion (Valancy et al, 2021;Villeneuve et al, 2021). Patients with both conditions may exhibit morphologically similar red blood cell and anemia symptoms.Therefore, physicians often mistake mild thalassemia for IDA and prescribe unnecessary iron supplements (Keramati & Maybodi, 2007;Jameel et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of microcytic hypochromic anemia with red blood cell survival via carbon monoxide breath-red blood cell survival

Li¹,

Deng

et al. 2022

Food Sci. Technol

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“…To further evaluate the associations between typical chest imaging findings and the primary and secondary outcomes, a propensity score analysis with 1:1 matching was performed. The following covariates were included based on previous studies (22)(23)(24)(25)(26): GA, BW, cesarean section, CAM, PIH, sepsis, RDS, PDA, prenatal glucocorticoid administration, postnatal glucocorticoid administration, NEC, IVH, RSD, IMV ≥ 7 days, ≥2 PRBC transfusions. The nearest neighbor matching method was used to select each matched pair by using calipers with a width equal to 0.01 of the standard deviation of the logit of the propensity score.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes Until 2 Years of Age in Preterm Infants With Typical Chest Imaging Findings of Bronchopulmonary Dysplasia: A Propensity Score Analysis

2021

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Objective: The goal of the current study was to assess the associations of typical chest imaging findings of bronchopulmonary dysplasia (BPD) in preterm infants with clinical characteristics and outcomes until 2 years of age.Method: This retrospective cohort study enrolled 256 preterm infants with BPD who were admitted between 2014 and 2018. A propensity score analysis was used to adjust for confounding factors. The primary outcomes were the severity of BPD, home oxygen therapy (HOT) at discharge and mortality between 28 days after birth and 2 years of age. A multivariate logistic regression analysis was performed to identify related variables of mortality.Results: Seventy-eight patients with typical chest imaging findings were enrolled, of which 50 (64.1%) were first found by CXR, while 28 (35.9%) were first found by CT. In addition, 85.9% (67/78) were discovered before 36 weeks postmenstrual age (PMA) (gestational age [GA] < 32 weeks) or before 56 days after birth (GA > 32 weeks). After propensity score matching, the matched groups consisted of 58 pairs of patients. Those with typical imaging findings had a remarkably higher mortality rate (29.3 vs. 12.1%, p = 0.022, OR 3.021), higher proportion of severe BPD (32.8 vs. 12.1%, p = 0.003, OR 4.669) and higher rate of HOT at discharge (74.1 vs. 46.6%, p = 0.002, OR 3.291) than those without typical imaging findings. The multivariate logistic regression analysis showed that typical imaging findings ≤ 7 days and typical typical imaging findings >7 days were independent risk factors for mortality in preterm infants with BPD (OR 7.794, p = 0.004; OR 4.533, p = 0.001).Conclusions: More attention should be given to chest imaging findings of BPD, especially in the early stage (within 7 days). Early recognition of the development of BPD helps early individualized treatment of BPD.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04163822.

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Neonatal red blood cell transfusion

Cited by 37 publications

References 103 publications

Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion

Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion

Diagnosis of microcytic hypochromic anemia with red blood cell survival via carbon monoxide breath-red blood cell survival

Clinical Characteristics and Outcomes Until 2 Years of Age in Preterm Infants With Typical Chest Imaging Findings of Bronchopulmonary Dysplasia: A Propensity Score Analysis

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