Long-term effects of liberal versus restricted red blood cell transfusions in extremely low birth weight infants: a meta analysis / 中国新生儿科杂志

ABSTRACT

Objective:To systematically analyze the effects of liberal and restrictive red blood cell transfusion strategies on mortality and neurodevelopmental impairment (NDI) of extremely low birth weight infant (ELBWI).Methods:From the establishment of the databases to March 2021, randomized controlled trials on this subject published in English or Chinese from databases (Pubmed, Embase, Cochrane Library, Web of science, Wanfang database, CNKI, VIP and CBM) were searched. The article selection process and data extraction were carried out by two independent investigators. RevMan 5.3 software was used for meta analysis.Results:The literature search yielded 692 pertinent articles and 4 studies were selected for meta-analysis. 3 577 ELBWI were followed up until corrected age of 22~26 months. Meta-analysis showed that restrictive and liberal transfusion thresholds had no significant effects on severe adverse outcomes (mortality+NDI) ( RR=1.01, 95% CI 0.94~1.08, Z=0.24, P=0.81), mortality rate ( RR=1.10, 95% CI 0.94~1.29, Z=1.24, P=0.22), NDI ( RR=0.98, 95% CI 0.89~1.07, Z=0.46, P=0.65) and cerebral palsy ( RR=1.21, 95% CI 0.89~1.66, Z=1.21, P=0.23) for ELBWI. Conclusions:Restricted and liberal blood transfusion have similar long-term effects on mortality and NDI of ELBWI. This may provide certain reference value guiding clinical blood transfusion in ELBWI.