Clinical analysis of red blood cell transfusions in infants with birth weight less than 1000 grama

doi:10.3969/j.issn.1005-2224.2001.04.013

Abstract：To investigate the possibility of reducing red blood celltransfusions in extremely low birth weight infants. Methods We performed a single-center analysis of 256 infants with birth weights from 500 to 999g who were admitted from 1989 to 1997 and included 3 study periods,each starting with newly modified transfusion guidelines in April 1989, September 1991, and January 1995. We evaluated previously recorded clinical data and retrospective chart analysis for transfusion-related information. Results Although nearly all infants received one or more red blood cell transfusions during the first 2 study periods,approximately one quarter received no transfusion during the last period. The mean number of transfusions per infant decreased from 7 in the first period to 2. 7 in the third period, whereas donor exposure decreased from 6. 3 to 1.5 and blood volume transfused decreased from 163.5 to 69. 2mL/kg birth weight( P＜ 0. 01 ). The overall survival rate was 78% and hospital stay didn't prolong. The incidences of retinopathy,intraventricular hemorrhage,and patent ductus arteriosus remained unchanged. Conclusions Over this 9-year period with increasingly restricitive transfusion guidelines,the transfusion number and the donor exposure decrease significantly in ELBW infants without adverse clinical effects.