Houben Nina A M, Fustolo-Gunnink Suzanne, Fijnvandraat Karin, Caram-Deelder Camila, Aguar Carrascosa Marta, Beuchée Alain, Brække Kristin, Cardona Francesco Stefano, Debeer Anne, Domingues Sara, Ghirardello Stefano, Grizelj Ruža, Hadžimuratović Emina, Heiring Christian, Lozar Krivec Jana, Maly Jan, Matasova Katarina, Moore Carmel Maria, Muehlbacher Tobias, Szabo Miklos, Szczapa Tomasz, Zaharie Gabriela, de Jager Justine, Reibel-Georgi Nora Johanna, New Helen V, Stanworth Simon J, Deschmann Emöke, Roehr Charles C, Dame Christof, le Cessie Saskia, van der Bom Johanna G, Lopriore Enrico
Sanquin Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands.
Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
Arch Dis Child Fetal Neonatal Ed. 2025 Aug 19;110(5):452-459. doi: 10.1136/archdischild-2024-327926.
Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.
Prospective observational study.
64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.
Preterm infants born below 32 weeks of gestational age.
Admission to the NICU.
Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.
A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5-30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).
We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.
ISRCTN17267090.
尽管缺乏支持疗效的证据，但预防性输注新鲜冰冻血浆和Octaplas可用于极早产儿以降低出血风险。新生儿重症监护病房（NICU）血浆输注实践的国际差异尚不清楚，因此，我们旨在描述欧洲新生儿血浆输注实践情况。
前瞻性观察性研究。
22个欧洲国家的64个NICU，每个中心在2022年9月至2023年8月期间有6周的研究期。
孕周小于32周的早产儿。
入住NICU。
血浆输注患病率、累积发病率、指征、输血量、输注速率及不良反应。
纳入的1143例婴儿中，共有92例（8.0%）在研究期间接受了血浆输注，共接受177次输血。总体患病率为每100个入院日0.3个血浆输血日，欧洲各地的发生率差异很大。到出生第28天，13.5%（95%CI 10.0%至16.9%）的婴儿接受了至少一次血浆输血，这是死亡或出院的竞争风险所致。输血指征广泛，包括活动性出血（29.4%）、凝血筛查结果异常（23.7%）和容量替代/低血压（21.5%）。输血量和输注速率差异显著；最常见的输血量为15 mL/kg（范围：5 - 30 mL/kg），最常见的输注持续时间为2小时（范围：30分钟至6小时）。
我们发现欧洲血浆输注实践存在很大差异，这突出表明需要有证据为新生儿科医生的日常实践和指南提供参考，特别是针对非出血指征。
ISRCTN17267090。
