학술논문
Variation in Neonatal Transfusion Practice
Document Type
article
Author
Patel, Ravi M; Hendrickson, Jeanne E; Nellis, Marianne E; Birch, Rebecca; Goel, Ruchika; Karam, Oliver; Karafin, Matthew S; Hanson, Sheila J; Sachais, Bruce S; Hauser, Ronald George; Luban, Naomi LC; Gottschall, Jerome; Josephson, Cassandra D; Sola-Visner, Martha; National Heart, Lung; Mast, AE; Hod, EA; Custer, BS; Vichinsky, EP; Spencer, BR; Mathew, SM; Harris, DR; Busch, MP; Norris, PJ; Ness, PM; Kleinman, SH; Tamburro, R; Glynn, SA; Malkin, K
Source
Subject
Language
Abstract
ObjectiveTo estimate the incidence of blood product transfusion, including red blood cells, platelets, and plasma, and characterize pretransfusion hematologic values for infants during their initial hospitalization after birth.Study designRetrospective cohort study using data from 7 geographically diverse US academic and community hospitals that participated in the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) from 2013 to 2016. Pretransfusion hematologic values were evaluated closest to each transfusion and no more than 24 hours beforehand.ResultsData from 60 243 infants were evaluated. The incidence of any transfusion differed by gestational age (P 45 for all gestational age groups examined. The median pretransfusion international normalized ratio for the entire cohort was 1.7 (10th-90th percentile 1.2-2.8).ConclusionsThere is wide variability in pretransfusion hemoglobin, platelet count, and international normalized ratio values for neonatal transfusions. Our findings suggest that a large proportion of neonatal transfusions in the US are administered at thresholds greater than supported by the best-available evidence and highlight an opportunity for improved patient blood management.