PT  - JOURNAL ARTICLE
AU  - Scrivens, Alexandra
AU  - Reibel, Nora Johanna
AU  - Heeger, Lisanne
AU  - Stanworth, Simon
AU  - Lopriore, Enrico
AU  - New, Helen V
AU  - Dame, Christof
AU  - Fijnvandraat, Karin
AU  - Deschmann, Emöke
AU  - Aguar, Marta
AU  - Brække, Kristin
AU  - Cardona, Francesco Stefano
AU  - Cools, Filip
AU  - Farrugia, Ryan
AU  - Ghirardello, Stefano
AU  - Lozar, Jana
AU  - Matasova, Katarina
AU  - Muehlbacher, Tobias
AU  - Sankilampi, Ulla
AU  - Soares, Henrique
AU  - Szabo, Miklos
AU  - Szczapa, Tomasz
AU  - Zaharie, Gabriela
AU  - Roehr, Charles Christoph
AU  - Fustolo-Gunnink, Suzanne
ED  - ,
TI  - Survey of transfusion practices in preterm infants in Europe
AID  - 10.1136/archdischild-2022-324619
DP  - 2023 Jan 18
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - fetalneonatal-2022-324619
4099  - http://fn.bmj.com/content/early/2023/01/18/archdischild-2022-324619.short
4100  - http://fn.bmj.com/content/early/2023/01/18/archdischild-2022-324619.full
AB  - Background Preterm infants commonly receive red blood cell (RBC), platelet and fresh frozen plasma (FFP) transfusions. The aim of this Neonatal Transfusion Network survey was to describe current transfusion practices in Europe and to compare our findings to three recent randomised controlled trials to understand how clinical practice relates to the trial data.Methods From October to December 2020, we performed an online survey among 597 neonatal intensive care units (NICUs) caring for infants with a gestational age (GA) of <32 weeks in 18 European countries.Results Responses from 343 NICUs (response rate: 57%) are presented and showed substantial variation in clinical practice. For RBC transfusions, 70% of NICUs transfused at thresholds above the restrictive thresholds tested in the recent trials and 22% below the restrictive thresholds. For platelet transfusions, 57% of NICUs transfused at platelet count thresholds above 25×109/L in non-bleeding infants of GA of <28 weeks, while the 25×109/L threshold was associated with a lower risk of harm in a recent trial. FFP transfusions were administered for coagulopathy without active bleeding in 39% and for hypotension in 25% of NICUs. Transfusion volume, duration and rate varied by factors up to several folds between NICUs.Conclusions Transfusion thresholds and aspects of administration vary widely across European NICUs. In general, transfusion thresholds used tend to be more liberal compared with data from recent trials supporting the use of more restrictive thresholds. Further research is needed to identify the barriers and enablers to incorporation of recent trial findings into neonatal transfusion practice.Data are available upon reasonable request. Data are available upon reasonable request by email to the corresponding and the senior author.