[Blood sampling and transfusion therapy in the preterm infant].

OBJECTIVE

The purpose of this study was to determine the number of skin punctures and volume of blood removed for analytical purposes and the number and volume of red blood cell transfusions performed in premature neonates.

PATIENTS AND METHODS

A case-control study was performed with a retrospective review of clinical records. Data about blood samples was gathered from the nursery forms and descriptive statistics were performed. Neonates less than 37 weeks gestational age, born in our hospital between 1/1/1992 and 12/31/1996, were studied. They were divided into two groups: Group 1) Those neonates receiving red blood cell transfusions; and Group 2) The control groups, which was comprised of the next premature baby born after each infant who underwent transfusion.

RESULTS

There were 419 premature infants out of 9,635 live newborns (4.3%). Of the 419 premature infants, 123 (29.3%) underwent transfusion therapy. The study groups after exclusions were comprised of 105 infants in groups 1 and 105 infants in the control group, or group 2. The average number of blood samples was 5.4 per infant (range 0-37). The mean volume of blood removed was 26.3 cc per infant (range 0-167 cc) or 15.1 cc/kg (birthweight). The total number of transfusions was 187, with a mean of 1.8 per infant (range 1-12). The mean volume transfused was 43.1 cc per infant (range 20-146 cc). The number of blood samples, total volume of blood removed and percentage of blood volume removed were significantly higher in the transfusion group than in the control group.

CONCLUSIONS

The number and volume of blood samples in our premature infants are excessive. We should reduce both to minimize the need of red blood cell transfusions and the associated risks.