Fabres Jorge, Wehrli Gay, Marques Marisa B, Phillips Vivien, Dimmitt Reed A, Westfall Andrew O, Schelonka Robert L
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
Transfusion. 2006 Nov;46(11):1915-20. doi: 10.1111/j.1537-2995.2006.00997.x.
Red blood cell (RBC) transfusions are crucial for the care of very-low-birth-weight (VLBW) infants. These infants frequently require multiple, small-volume RBC transfusions, with potential exposure to multiple donors. Optimal protocols provide dedicated RBC units to reduce exposures and avoid RBC wastage.
This study was a retrospective, single-institution review of RBC transfusions in VLBW infants. The RBC volume transfused during the entire hospitalization (VTH) and that transfused at 35 days were determined for all infants, 401 to 1250 g at birth, admitted to a Level III neonatal intensive care unit from January 1, 2000, through December 31, 2002. Multivariable models identified perinatal factors associated with volume transfused.
The 640-infant cohort had a median birth weight (BW) of 818 g and gestational age (GA) of 26 weeks. Most infants (546 or 85%) required at least one RBC transfusion. Median number of RBC transfusions was 3 (range, 0-30) and median volume transfused was 82 mL (range, 9-737 mL). Of 328 infants who received all transfusions within a 35-day period, only 5 (1.5%) required at least 200 mL. VTH was inversely related to BW and GA. Multivariable models identified BW, GA, age at first transfusion, and use of inotropes as variables associated with higher volume transfused.
Few VLBW infants use an entire RBC unit. One dedicated unit shared by two or more infants should meet their transfusion needs. GA, BW, and markers of illness severity predict increased RBC volume requirements.
红细胞（RBC）输血对于极低出生体重（VLBW）婴儿的护理至关重要。这些婴儿经常需要多次小剂量的RBC输血，可能会接触多个供血者。最佳方案是提供专用的RBC单位以减少接触并避免RBC浪费。
本研究是对VLBW婴儿RBC输血情况进行的一项回顾性单机构研究。确定了2000年1月1日至2002年12月31日期间入住三级新生儿重症监护病房、出生体重401至1250克的所有婴儿在整个住院期间（VTH）以及35天时输注的RBC量。多变量模型确定了与输血量相关的围产期因素。
640名婴儿队列的中位出生体重（BW）为818克，中位胎龄（GA）为26周。大多数婴儿（546名或85%）至少需要一次RBC输血。RBC输血的中位数为3次（范围0 - 30次），输注量的中位数为82毫升（范围9 - 737毫升）。在35天内接受所有输血的328名婴儿中，只有5名（1.5%）需要至少200毫升。VTH与BW和GA呈负相关。多变量模型确定BW、GA、首次输血时的年龄以及使用血管活性药物是与较高输血量相关的变量。
很少有VLBW婴儿会用完一整个RBC单位。由两名或更多婴儿共享一个专用单位应能满足他们的输血需求。GA、BW和疾病严重程度指标可预测RBC需求量增加。
