Klinger Gil, Helenius Kjell, Vento Maximo, Kusuda Satoshi, Norman Mikael, Procianoy Renato Soibelman, Goswami Neha, Biran Valerie, Bassler Dirk, Reichman Brian, Skubisz Aleksandra, Battin Malcolm, Lehtonen Liisa, Lui Kei, Mori Annalisa, Beltempo Marc, Adams Mark, San Feliciano Laura, Isayama Tetsuya, Shah Prakesh S
Department of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Tel Aviv University, Tel Aviv, Israel.
Neonatology. 2025 May 28:1-9. doi: 10.1159/000546612.
Recent evidence suggests a restrictive approach toward blood transfusions for management of preterm infants. Objective was to survey blood transfusion practises in preterm neonates <29 weeks' gestation among 12 population-based neonatal networks participating in the International Network for Evaluating Outcomes in Neonates (iNeo).
An online survey based on 2023 practices was sent to 608 neonatal intensive care units (NICUs): Australia/New Zealand (30), Brazil (20), Canada (32), Finland (5), France (70), Israel (26), Japan (292), Poland (56), Spain (55), Sweden (9), Switzerland (9), and Tuscany, Italy (4). Transfusion thresholds in 4 different scenarios were surveyed: (a) infants invasively ventilated within first 7 postnatal days, (b) infants invasively ventilated after 7 days, (c) stable infants on noninvasive respiratory support, and (d) stable infants requiring no respiratory support.
A total of 382 NICUs (63%) responded. Transfusion practices varied within networks and between countries. For invasively ventilated infants, the transfusion threshold during first 7 days after birth was a hematocrit
Variations exist in blood transfusion practises between countries and within networks. A restrictive transfusion approach based on recent recommendations has been adopted by more than two-thirds of NICUs. Additional research is needed to evaluate whether practices align with intentions and how they impact outcomes.
近期证据表明，对于早产儿的管理应采取限制性输血方法。目的是调查参与国际新生儿结局评估网络（iNeo）的12个基于人群的新生儿网络中孕龄小于29周的早产儿的输血实践。
基于2023年的实践开展了一项在线调查，发送给608个新生儿重症监护病房（NICU）：澳大利亚/新西兰（30个）、巴西（20个）、加拿大（32个）、芬兰（5个）、法国（70个）、以色列（26个）、日本（292个）、波兰（56个）、西班牙（55个）、瑞典（9个）、瑞士（9个）以及意大利托斯卡纳地区（4个）。调查了4种不同情况下的输血阈值：（a）出生后前7天内接受有创通气的婴儿；（b）7天后接受有创通气的婴儿；（c）接受无创呼吸支持的稳定婴儿；（d）不需要呼吸支持的稳定婴儿。
共有382个NICU（63%）做出回应。各网络之间以及各国之间的输血实践存在差异。对于接受有创通气的婴儿，出生后前7天的输血阈值为血细胞比容≤35%的情况在79%的NICU中出现，而在年龄≥8天时，输血阈值为血细胞比容≤30%的情况在68%的NICU中出现。对于接受无创通气的稳定婴儿，输血阈值为血细胞比容≤30%的情况在80%的NICU中出现，而对于那些不需要呼吸支持的婴儿，输血阈值为血细胞比容≤25%的情况在68%的NICU中出现。
各国之间以及各网络内部的输血实践存在差异。超过三分之二的NICU采用了基于近期建议的限制性输血方法。需要进一步研究来评估实践是否符合意图以及它们如何影响结局。
