Document Detail


A very strict guideline reduces the number of erythrocyte transfusions in preterm infants.
MedLine Citation:
PMID:  18544122     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Benefits of adopting restrictive guidelines for erythrocyte transfusions are still controversial. The objective of this study was to verify if a very strict guideline could reduce erythrocyte transfusions in preterm infants without adverse outcomes. MATERIALS AND METHODS: Two prospective cohorts of neonates with gestational age < 37 weeks and birth weight < 1500 g were studied. Neonates born in Period 1 were submitted to a strict guideline for erythrocyte transfusions. In Period 2, a new stricter protocol was introduced. Infants of both periods were compared regarding number of transfusions and clinical outcome. RESULTS: The median number of transfusions decreased from 2 (1 to 14) in Period 1 to 1 (1-9), P = 0.001, in Period 2. The linear regression multivariate analysis showed that the implementation of the stricter guideline was associated with a reduction in the number of transfusions received by patients by 0.55 (95% confidence interval: -0.08; -1.02) units/patients. Number of apnea episodes, weight at 28 days of life and days of hospital stay were similar in both periods. Intra-hospital death was lower in Period 2. CONCLUSION: A very strict guideline reduced the number of erythrocyte transfusions in preterm infants, without threatening their clinical course.
Authors:
A F M A Mimica; A M N dos Santos; D H F da Cunha; R Guinsburg; J O Bordin; A Chiba; M M O Barros; B I Kopelman
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2008-06-09
Journal Detail:
Title:  Vox sanguinis     Volume:  95     ISSN:  1423-0410     ISO Abbreviation:  Vox Sang.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-13     Completed Date:  2008-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413606     Medline TA:  Vox Sang     Country:  England    
Other Details:
Languages:  eng     Pagination:  106-11     Citation Subset:  IM    
Affiliation:
Division of Neonatal Medicine, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Anoxia / epidemiology,  prevention & control
Apnea / epidemiology
Cerebral Hemorrhage / epidemiology
Cohort Studies
Erythrocyte Transfusion / standards,  utilization*
Female
Gestational Age
Guideline Adherence*
Hematocrit
Hospital Mortality
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology,  prevention & control,  therapy*
Infant, Small for Gestational Age
Infant, Very Low Birth Weight
Length of Stay / statistics & numerical data
Male
Phlebotomy / adverse effects
Positive-Pressure Respiration / utilization
Practice Guidelines as Topic*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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