Jena Pravati, Rout Rojalin, Gudu Rama K, Pradhan Deepti D, Panda Santosh K
Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Neonatology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2025 Jul 10;17(7):e87657. doi: 10.7759/cureus.87657. eCollection 2025 Jul.
The purpose of this study was to ascertain the appropriate packed red blood cell transfusion (PRBCT) practice for preterm infants consistent with multiple international guidelines.
This retrospective study was conducted at a tertiary care center in India from February 2019 to December 2020. All preterm neonates born at <32 weeks of gestation who received PRBCTs during the study period were included. The hemoglobin (Hb) levels at the time of transfusion were analyzed to assess adherence to the transfusion thresholds recommended by the British Committee for Standards in Haematology (BCSH), Canadian Blood Services (CBS), and the Australian National Blood Authority (ANBA), considering postnatal age and the need for respiratory support.
A total of 43 preterm neonates (gestational age, 28.08±1.08 weeks; birth weight, 1,018±0.027 g) received 78 PRBCTs. Specifically, nine (11.5%) PRBCTs were given in the first week, 14 (18%) in the second week, and 55 (70.5%) at three or more weeks of age. Further, nine (11.5%) PRBCTs were given during mechanical ventilation (MV), 49 (63%) with non-invasive ventilation (NIV) or oxygen (O₂) support, and 20 (25.5%) without O₂ support. The appropriateness of all of the PRBCTs per the BCSH, CBS, and ANBA guidelines was 63/78 (80.7%), 58/78 (74.3%), and 78/78 (100%), respectively. Most of the neonates on respiratory support received PRBCTs in a manner consistent with the CBS, BCSH, and ANBA guidelines, whereas most of the neonates not on oxygen (O₂) therapy received PRBCTs for late anemia (at three weeks or more of age) at a higher Hb level than that suggested by the CBS and BCSH guidelines but consistent with the ANBA guidelines.
In this transfusion audit study, liberal PRBCT practice was observed for late anemia among stable preterm infants, consistent with the CBS and BCSH blood transfusion guidelines. Hence, there is room for improvement in PRBCT policies in terms of quality-improvement interventions to prevent over-transfusion.
本研究旨在确定符合多项国际指南的早产儿合适的红细胞输注（PRBCT）方案。
本回顾性研究于2019年2月至2020年12月在印度一家三级医疗中心进行。纳入研究期间所有孕周<32周且接受PRBCT的早产儿。分析输血时的血红蛋白（Hb）水平，以评估是否符合英国血液学标准委员会（BCSH）、加拿大血液服务中心（CBS）和澳大利亚国家血液管理局（ANBA）推荐的输血阈值，同时考虑出生后年龄和呼吸支持需求。
共有43例早产儿（胎龄28.08±1.08周；出生体重1018±0.027g）接受了78次PRBCT。具体而言，9次（11.5%）PRBCT在第一周进行，14次（18%）在第二周进行，55次（70.5%）在三周及以上进行。此外，9次（11.5%）PRBCT在机械通气（MV）期间进行，49次（63%）在无创通气（NIV）或吸氧（O₂）支持下进行，20次（25.5%）在无O₂支持下进行。按照BCSH、CBS和ANBA指南，所有PRBCT的适宜率分别为63/78（80.7%）、58/78（74.3%）和78/78（100%）。大多数接受呼吸支持的新生儿接受PRBCT的方式符合CBS、BCSH和ANBA指南，而大多数未接受吸氧（O₂）治疗的新生儿因晚期贫血（三周及以上）接受PRBCT时的Hb水平高于CBS和BCSH指南建议，但符合ANBA指南。
在这项输血审核研究中，观察到稳定早产儿晚期贫血的PRBCT方案较为宽松，符合CBS和BCSH输血指南。因此，在预防过度输血的质量改进干预方面，PRBCT政策仍有改进空间。
