RT Journal Article
SR Electronic
T1 Survey of transfusion practices in preterm infants in Europe
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP fetalneonatal-2022-324619
DO 10.1136/archdischild-2022-324619
A1 Scrivens, Alexandra
A1 Reibel, Nora Johanna
A1 Heeger, Lisanne
A1 Stanworth, Simon
A1 Lopriore, Enrico
A1 New, Helen V
A1 Dame, Christof
A1 Fijnvandraat, Karin
A1 Deschmann, Emöke
A1 Aguar, Marta
A1 Brække, Kristin
A1 Cardona, Francesco Stefano
A1 Cools, Filip
A1 Farrugia, Ryan
A1 Ghirardello, Stefano
A1 Lozar, Jana
A1 Matasova, Katarina
A1 Muehlbacher, Tobias
A1 Sankilampi, Ulla
A1 Soares, Henrique
A1 Szabo, Miklos
A1 Szczapa, Tomasz
A1 Zaharie, Gabriela
A1 Roehr, Charles Christoph
A1 Fustolo-Gunnink, Suzanne
A1 ,
YR 2023
UL http://fn.bmj.com/content/early/2023/01/18/archdischild-2022-324619.abstract
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.