Survey of transfusion practices in preterm infants in Europe.

Fecha de publicación: 18/01/2023 Fecha Ahead of Print: 18/01/2023

Autores de IIS La Fe

Marta Aguar Carrascosa

Autor

Participantes ajenos a IIS La Fe

Scrivens, Alexandra
Reibel, Nora Johanna
Heeger, Lisanne
Stanworth, Simon
Lopriore, Enrico
New, Helen V
Dame, Christof
Fijnvandraat, Karin
Deschmann, Emoke
Brække K
Cardona, Francesco Stefano
Cools, Filip
Farrugia, Ryan
Ghirardello, Stefano
Lozar, Jana
Matasova, Katarina
Muehlbacher, Tobias
Sankilampi, Ulla
Soares, Henrique
Szabo, Miklos
Szczapa, Tomasz
Zaharie, Gabriela
Roehr, Charles Christoph
Fustolo-Gunnink, Suzanne
Neonatal Transfusion Network

Grupos

Perinatología

Leader

Máximo Vento Torres

Abstract

BACKGROUND: Preterm infants commonly receive red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusions. The aim of this Neonatal Transfusion Network survey was to describe current transfusion practices in Europe and to compare our findings to three recent randomised controlled trials to understand how clinical practice relates to the trial data. METHODS: From October to December 2020, we performed an online survey among 597 neonatal intensive care units (NICUs) caring for infants with a gestational age (GA) of <32 weeks in 18 European countries. RESULTS: Responses from 343 NICUs (response rate: 57%) are presented and showed substantial variation in clinical practice. For RBC transfusions, 70% of NICUs transfused at thresholds above the restrictive thresholds tested in the recent trials and 22% below the restrictive thresholds. For platelet transfusions, 57% of NICUs transfused at platelet count thresholds above 25×10(9)/L in non-bleeding infants of GA of <28 weeks, while the 25×10(9)/L threshold was associated with a lower risk of harm in a recent trial. FFP transfusions were administered for coagulopathy without active bleeding in 39% and for hypotension in 25% of NICUs. Transfusion volume, duration and rate varied by factors up to several folds between NICUs. CONCLUSIONS: Transfusion thresholds and aspects of administration vary widely across European NICUs. In general, transfusion thresholds used tend to be more liberal compared with data from recent trials supporting the use of more restrictive thresholds. Further research is needed to identify the barriers and enablers to incorporation of recent trial findings into neonatal transfusion practice.

Datos de la publicación

ISSN/ISSNe:: 1359-2998, 1468-2052
Tipo:: Article
Páginas:: 360-366
DOI:: 10.1136/archdischild-2022-324619
Factor de Impacto:: 1,837 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Scrivens, Alexandra:: Newborn Care Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Reibel, Nora Johanna:: Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany
Stanworth, Simon:: Department of Haematology, National Health Service, Blood and Transplant, Oxford University Hopsitals NHS Foundation Trust, Oxford, UK
New, Helen V:: Paediatric Transfusion Medicine, National Health Service, Blood and Transplant, London, UK
Dame, Christof:: Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Deschmann, Emoke:: University Hospital, Stockholm, Karolinska Institute, Stockholm, Sweden
Aguar, Marta:: Servicio de Neonatologia, University & Polytechnic Hospital La Fe, Valencia, Spain
Brække K:: Women and Children's division, Department of Neonatal Intensive Care, Ullevål, Oslo University Hospital, Oslo, Norway
Cardona, Francesco Stefano:: Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care and Pediatric Neurology, Medical University of Vienna, Wien, Austria
Cools, Filip:: Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
Farrugia, Ryan:: Pediatrics, Mater Dei Hospital, Msida, Malta
Ghirardello, Stefano:: Neonatal Intensive Care and Neonatology Unit, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
Lozar, Jana:: Neonatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Muehlbacher, Tobias:: Neonatology, University Hospital Zurich, Zurich, Switzerland
Sankilampi, Ulla:: Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
Soares, Henrique:: Neonatology, Centro Hospitalar Universitário de São João, Porto, Portugal
Szabo, Miklos:: Division of Neonatology 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
Szczapa, Tomasz:: II Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
Zaharie, Gabriela:: Neonatology, University of Medicine and Pharmacy Iuliu Hatieganu Cluj, Cluj Napoca, Romania
Roehr, Charles Christoph:: Women and Children's, Neonatal Intensive Care Unit, Southmead Hospital, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
Fustolo-Gunnink, Suzanne:: Pediatric Hematology, Amsterdam University Medical Center, Amsterdam, Netherlands