Short-Term Blood Transfusion Outcomes in Preterm Infants admitted to Neonatal Intensive Care Unit (NICU): A Retrospective Analytical Study

Abstract

Background: Red blood cell (RBC) transfusions in preterm infants have been associated with increased risk of short-term morbidities, as necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP) and intracranial hemorrhage (ICH). Aim of work: To study the relationship between RBC transfusions and short-term morbidities in preterm infants. Patients and Methods: Retrospectively, the relationship between RBC transfusions, number of transfusions and short-term morbidities were investigated in the first week and month over two years from 1 st March 2018 to 29 th February, 2020. One hundred sixty-one preterm infants were included: 91 females and 70 males who were ≤ 32 weeks of gestation and 1500 grams. Results: First week transfusions significantly correlated with the incidence and severity of ROP and BPD (P-value 0.012 & 0.014 for ROP) and (Pvalue 0.001 for the incidence and severity of BPD) and only the incidence of NEC and ICH regardless of the number of transfusions (P-value <0.001 for both), except for the outcome, where number of transfusions was significant in addition (P-value 0.007) compared to a highly significant outcome in relation to first week transfusion (P-value <0.001). First month transfusions were considerably associated with the incidence and severity of ROP (P-value <0.001 for both) and only associated with the incidence of NEC, ICH, and BPD (P-value of <0.001 for all). First month number of transfusions significantly correlated with the incidence and severity of BPD (P-value 0.024 & and 0.006 respectively) and the outcome (P-value 0.004). Conclusion: RBCs transfusion should be limited to the extremely indicated preterm infants especially in the first month of life.

Survey on Pattern and Determinants of Blood Transfusion in Benha Neonatal Intensive Unit

“…In the present study, regarding need of oxygen: 31.7 of cases needed MV, 27.3 needed CPAP, 27.4 needed nasal prongs, while 13.7 didn't need oxygen support. Which supports our findings; Gomaa and Abdelkhalik (17) found a moderately positive link between the quantity of transfusions and the length of mechanical ventilation as well as a moderately negative correlation between the quantity of transfusions and the length of CPAP. A strong negative correlation existed between the amount of transfusions received in the first month, birth weight, and gestational age.…”

“…Similarly, Liao et al (12) , found that time of hospital stay in observation group was (41±16.9) days, and in control group was (18±7.4) days. RBC transfusion in the first week was essentially related to death in preterm neonates as shown in the study of Gomaa and Abdelkhalik (17) and Wang et al 20) . Vamvakas and Blajchman (21) suggested that transfusion may be associated with multi-organ system failure, pro-inflammatory mechanisms, and transfusionrelated immunomodulation.…”