Document Detail


Long-term outcome of brain structure in premature infants: effects of liberal vs restricted red blood cell transfusions.
MedLine Citation:
PMID:  21199970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the long-term outcome of brain structure in preterm infants, at an average age of 12 years, who received a red blood cell transfusion for anemia of prematurity.
DESIGN: As neonates, this cohort of infants participated in a clinical trial in which they received red blood cell transfusions based on a high pretransfusion hematocrit threshold (liberal group) or a low hematocrit threshold (restricted group). These 2 preterm groups were compared with a group of full-term healthy control children.
SETTING: Tertiary care hospital.
PARTICIPANTS: Magnetic resonance imaging scans for 44 of the original 100 subjects were obtained.
INTERVENTION: Liberal vs restricted transfusion.
MAIN OUTCOME MEASURES: Intracranial volume, total brain tissue, total cerebrospinal fluid, cerebral cortex and cerebral white matter volume, subcortical nuclei volume, and cerebellum volume.
RESULTS: Intracranial volume was substantially smaller in the liberal group compared with controls. Intracranial volume in the restricted group was not different from controls. Whole-cortex volume was not different in either preterm group compared with controls. Cerebral white matter was substantially reduced in both preterm groups, more so for the liberal group. The subcortical nuclei were substantially decreased in volume, equally so for both preterm groups compared with controls. When sex effects were evaluated, the girls in the liberal group had the most significant abnormalities.
CONCLUSION: Red blood cell transfusions affected the long-term outcome of premature infants as indicated by reduced brain volumes at 12 years of age for neonates who received transfusions using liberal guidelines.
Authors:
Peg C Nopoulos; Amy L Conrad; Edward F Bell; Ronald G Strauss; John A Widness; Vincent A Magnotta; M Bridget Zimmerman; Michael K Georgieff; Scott D Lindgren; Lynn C Richman
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-01-03
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  165     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-03     Completed Date:  2011-07-11     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  443-50     Citation Subset:  AIM; IM    
Affiliation:
University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA. peggy-nopoulos@uiowa.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00369005
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Anemia, Neonatal / diagnosis,  therapy*
Brain / pathology*
Child
Child Development / physiology*
Child, Preschool
Erythrocyte Transfusion / adverse effects,  methods*
Female
Follow-Up Studies
Hematocrit / methods*
Humans
Infant
Infant, Newborn
Infant, Premature*
Magnetic Resonance Imaging / methods
Male
Reference Values
Risk Assessment
Sex Factors
Time Factors
Grant Support
ID/Acronym/Agency:
2 P01 HL04 6925/HL/NHLBI NIH HHS; P01 HL046925/HL/NHLBI NIH HHS
Comments/Corrections

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