What Is New about Transfusions for Preterm Infants? An Update.
Neonatology
; 115(4): 406-410, 2019.
Article
em En
| MEDLINE
| ID: mdl-30974429
ABSTRACT
Currently the question of whether to maintain a higher hemoglobin level by transfusing more liberally, as opposed to a more restrictive strategy with lower hemoglobin maintenance levels, has not been answered. We review summarized conclusions of a Cochrane systematic review and meta-analysis of 614 infants in 4 randomized controlled trials (RCT) pooling data. This suggests potential benefits of higher hemoglobin levels, i.e., a possible improved cognition of infants at 18-21 months' corrected age and a reduction of apnea. However, the data on cognition is hypothesis generating as it derives from a post hoc analysis from a single trial in 451 infants. Moreover, the data on apnea need confirmation in larger trials. The effect of adding data of cognitive 2-year outcomes of 1,744 infants from 2 RCT, which will be reported soon, should expand our understanding. This new data will need to be integrated with the older generation of RCTs but also with emerging suggestions from observational data on potential risks of blood transfusions. We discuss some of these warnings from observational studies. Finally, we ask whether we are ready to individualize blood transfusion to physiological measures made in individual infants, and we point to some current difficulties hindering this step.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Fomentar_producao_conhecimento_especifico
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Recém-Nascido de Baixo Peso
/
Recém-Nascido Prematuro
/
Transfusão de Eritrócitos
/
Anemia Neonatal
Tipo de estudo:
Clinical_trials
/
Etiology_studies
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Observational_studies
/
Systematic_reviews
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Neonatology
Ano de publicação:
2019
Tipo de documento:
Article