Strict red blood cell transfusion guideline reduces the need for transfusions in very-low-birthweight infants in the first 4 weeks of life: a multicentre trial
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2005-02-01
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Dos Santos, Amelia Miyashiro 
Guinsburg, Ruth
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Background and Objectives Very-low-birthweight infants are among the most heavily transfused patients. the objective of this study was to verify if the introduction of a strict guideline would reduce the need for red blood cell transfusions in the first 4 weeks of life in these neonates.Materials and Methods This was a multicentre prospective study of two cohorts of very-low-birthweight infants transfused in accordance with the recommendations of a neonatologist (Phase 1) or according to previously published guidelines (Phase 2).Results in the first 28 days of life, 102 patients (68.5%) in Phase 1 and 117 (59.7%) in Phase 2 were transfused. the number of transfusions was 1.9 +/- 2.0 in Phase 1 and 1.4 +/- 1.6 in Phase 2 (P = 0.01). After adjusting for gestational age, blood loss and the presence of respiratory distress syndrome, the strict guideline reduced the number of transfusions in 17.6% (IC 95%-30.5% to -2.6%).Conclusions the strict guideline was effective in reducing erythrocyte transfusions in very-low-birthweight infants.
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Vox Sanguinis. Oxford: Blackwell Publishing Ltd, v. 88, n. 2, p. 107-113, 2005.