Document Detail

Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units.
MedLine Citation:
PMID:  19709390     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Guidelines for red blood cell (RBC) transfusions exist; however, transfusion practices vary among centers. This study aimed to analyze transfusion practices and the impact of patients and institutional characteristics on the indications of RBC transfusions in preterm infants. STUDY DESIGN AND METHODS: RBC transfusion practices were investigated in a multicenter prospective cohort of preterm infants with a birth weight of less than 1500 g born at eight public university neonatal intensive care units of the Brazilian Network on Neonatal Research. Variables associated with any RBC transfusions were analyzed by logistic regression analysis. RESULTS: Of 952 very-low-birth-weight infants, 532 (55.9%) received at least one RBC transfusion. The percentages of transfused neonates were 48.9, 54.5, 56.0, 61.2, 56.3, 47.8, 75.4, and 44.7%, respectively, for Centers 1 through 8. The number of transfusions during the first 28 days of life was higher in Center 4 and 7 than in other centers. After 28 days, the number of transfusions decreased, except for Center 7. Multivariate logistic regression analysis showed higher likelihood of transfusion in infants with late onset sepsis (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8-4.4), intraventricular hemorrhage (OR, 9.4; 95% CI, 3.3-26.8), intubation at birth (OR, 1.7; 95% CI, 1.0-2.8), need for umbilical catheter (OR, 2.4; 95% CI, 1.3-4.4), days on mechanical ventilation (OR, 1.1; 95% CI, 1.0-1.2), oxygen therapy (OR, 1.1; 95% CI, 1.0-1.1), parenteral nutrition (OR, 1.1; 95% CI, 1.0-1.1), and birth center (p < 0.001). CONCLUSIONS: The need of RBC transfusions in very-low-birth-weight preterm infants was associated with clinical conditions and birth center. The distribution of the number of transfusions during hospital stay may be used as a measure of neonatal care quality.
Am?lia M N dos Santos; Ruth Guinsburg; Renato S Procianoy; L?lian dos S R Sadeck; Abimael Aranha Netto; Ligia M Rugolo; Jorge H Luz; Olga Bomfim; Francisco E Martinez; Maria Fernanda B de Almeida;
Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-08-26
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-03-17     Completed Date:  2010-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-9     Citation Subset:  IM    
Hospital S?o Paulo, Universidade Federal de S?o Paulo, S?o Paulo, SP, Brazil.
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MeSH Terms
Apgar Score
Brazil / epidemiology
Diabetes, Gestational / epidemiology
Erythrocyte Transfusion / statistics & numerical data*
Guideline Adherence / statistics & numerical data
Hospitals, Public / statistics & numerical data
Hospitals, University / statistics & numerical data*
Hypertension, Pregnancy-Induced / epidemiology
Infant, Newborn
Infant, Newborn, Diseases / epidemiology*,  therapy*
Infant, Premature*
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal / statistics & numerical data*
Length of Stay / statistics & numerical data
Logistic Models
Multivariate Analysis
Practice Guidelines as Topic
Am?lia Miyashiro Nunes dos Santos / ; Ruth Guinsburg / ; Maria Fernanda Branco de Almeida / ; Daniela Miguel Gibertoni / ; Renato Soibelmann Procianoy / ; Rita de C?ssia Silveira / ; Luciana Alonzo Heidemann / ; L?lian dos Santos Rodrigues Sadeck / ; Cl?a Rodrigues Leone / ; Vera Lucia Jornada Krebs / ; Abimael Aranha Netto / ; S?rgio Tadeu Martins Marba / ; Fernanda de Castro Millen / ; Ligia Maria Suppo de Souza Rugolo / ; Adriana Saito / ; Maria Regina Bentlin / ; JorgeHecker Luz / ; Humberto Holmer Fiori / ; Renato Machado Fiori / ; Manuel Ruttkay Pereira / ; Alexandre Holmer Fiori / ; Olga Bomfim / ; Jos? Maria de Andrade Lopes / ; Francisco Eul?gio Martinez / ; Walusa Assad Gon?alves / ; Maria L?cia Silveira Ferlin /

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