Changing patterns of red blood cell transfusion in very low birth weight infants☆,☆☆,★,★★
Section snippets
Protocol design
Changes in the pattern of administering RBC transfusions to VLBW infants admitted to our nursery were assessed for the past 12 years by retrospectively examining blood bank and hospital records. Three study years were selected to encompass major events having a potential impact on RBC transfusion practices. The first year selected, 1982, immediately preceded widespread awareness of human immunodeficiency virus. The second year, 1989, preceded implementation of major changes in the prevention
RESULTS
General characteristics indicative of the degree of prematurity and clinical condition at birth were similar for each of the 3 study years (Table I). The only exceptions were a greater proportion of girls in 1989 than in 1993, and a lower initial postdelivery hemoglobin concentration in 1989 than in 1982. Although Apgar scores at 1 and 5 minutes were not different (data not shown), the infant mortality rate before 2 weeks of age was significantly lower in 1993 than in either 1982 or 1989 (p
DISCUSSION
During the 12 years from 1982 to 1993, we observed a 30% decline in the number of infants weighing 1.5 kg or less who received one or more RBC transfusions, a 67% reduction in the number of transfusions administered per infant, and a 54% decrease in the number of donor exposures per infant before hospital discharge or transfer. These events occurred during a period of improving survival and outcome. Although surveys of RBC transfusions done in the 1970s and 1980s noted a reduction in the number
Acknowledgements
We acknowledge the skillful assistance of Christopher J. McDonald, Terrie L. James, RN, June E. Miller, RN, and Karen J. Johnson, RN, in data collection. Encouragement and helpful suggestions were provided by Charles A. J. Wardrop, MB, FRCPE, FRCPATH.
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Cited by (0)
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From the Departments of Pediatrics, Preventive Medicine, and Pathology, University of Iowa, Iowa City
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Supported by National Institutes of Health grant PO1 HL46925.
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Reprint requests: John A. Widness, MD, Department of Pediatrics, University of Iowa, Iowa City, IA 52242.
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0022-3476/96/$5.00 + 0 9/21/75549