Shafique Muhammed A, Abbas Syeda Q, Habiba Ume, Mughal Aira, Fadlalla Ahmad Tagwa Kalool, Munir Chaudhary Anfal
Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Medicine, Ahfad University for Women, Omdurman, Sudan.
Ann Med Surg (Lond). 2024 Jan 23;86(3):1550-1562. doi: 10.1097/MS9.0000000000001751. eCollection 2024 Mar.
Blood transfusion intervention has been proven to be a crucial therapeutic aid for preterm infants with serious morbidities such as sepsis, intraventricular hemorrhage, and cardiopulmonary insufficiencies. However, blood transfusion practices have also been shown to cause significant adverse outcomes, which may negate the therapeutic effect of the intervention. To address the varying policies regarding the administration of blood products, healthcare professionals have adopted a consensus-based approach. The absence of a standard protocol has resulted in conflicting outcomes in previous clinical studies.
This study aimed to evaluate the effectiveness of blood transfusion practices in preterm infants by analyzing past clinical research and identifying the current trends that have emerged as a result of recent trials.
Recent trials have demonstrated comparable trends in mortality rates and other primary outcomes, including retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia, and brain injury, following transfusion of blood products in both groups. Nevertheless, employing restrictive thresholds rather than adopting a liberal approach can reduce these outcomes.
The current literature does not provide clear support for either technique as opposing and contradictory results are evident. However, there is a slight inclination toward the restrictive transfusion threshold due to recent trials, which warrants further in-depth investigation into this issue.
输血干预已被证明是患有败血症、脑室内出血和心肺功能不全等严重疾病的早产儿的关键治疗辅助手段。然而，输血操作也被证明会导致显著的不良后果，这可能会抵消干预措施的治疗效果。为了解决关于血液制品输注的不同政策，医疗保健专业人员采用了基于共识的方法。缺乏标准方案导致先前临床研究结果相互矛盾。
本研究旨在通过分析既往临床研究并确定近期试验所产生的当前趋势，评估输血操作对早产儿的有效性。
近期试验表明，两组输注血液制品后，死亡率及其他主要结局，包括早产儿视网膜病变、脑室内出血、支气管肺发育不良和脑损伤，呈现出可比的趋势。然而，采用限制性阈值而非宽松方法可降低这些结局。
由于明显存在相反和矛盾的结果，当前文献并未明确支持任何一种技术。然而，近期试验显示略微倾向于限制性输血阈值，这值得对该问题进行进一步深入研究。
