Your browser doesn't support javascript.
loading
Effect of Minimization of Early Blood Sampling Losses Among Extremely Premature Neonates: A Randomized Clinical Trial.
Balasubramanian, Haribalakrishna; Bhanushali, Mayuri; Tripathi, Vimmi; Srinivasan, Lakshmi; Sakharkar, Sachin; Pillai, Anish; Kabra, Nandkishor S.
Afiliación
  • Balasubramanian H; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India. Electronic address: drhari@suryahospitals.com.
  • Bhanushali M; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
  • Tripathi V; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
  • Srinivasan L; Department of Neonatology, The Children Hospital of Philadelphia, USA.
  • Sakharkar S; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
  • Pillai A; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
  • Kabra NS; Department of Neonatology, Surya Children's Hospital, Mumbai, Maharashtra, India.
J Pediatr ; 269: 114002, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38447757
ABSTRACT

OBJECTIVE:

To evaluate the effect of blood sampling stewardship on transfusion requirements among infants born extremely preterm. STUDY

DESIGN:

In this single-center, randomized controlled trial (RCT), infants born at <28 weeks of gestation and birth weight of <1000 g were randomized at 24 hours of age to two different blood sampling approaches restricted sampling (RS) vs conventional sampling (CS). The stewardship intervention in the RS group included targeted reduction in blood sampling volume and frequency and point of care testing methods in the first 6 weeks after birth. Both groups received early recombinant erythropoietin from day three of age. Primary outcome was the rate of early red blood cell (RBC) transfusions in the first six postnatal weeks.

RESULTS:

A total of 102 infants (mean gestational age 26 weeks; birth weight 756 g) were enrolled. Fidelity to the sampling protocol was achieved in 95% of the infants. Sampling losses in the first 6 weeks were significantly lower in the RS group (16.8 ml/kg vs 23.6 ml/kg, P < .001). The RS group had a significantly lower rate of early postnatal RBC transfusions (41% vs 73%, RR 0.56 [0.39-0.81], P = .001). The hazard of needing a transfusion during neonatal intensive care unit (NICU) stay was reduced by 55% by RS. Mortality and neonatal morbidities were similar between the two groups.

CONCLUSION:

Minimization of blood sampling losses by approximately one-third in the first 6 weeks after birth leads to substantial reduction in the early red blood cell transfusion rate in infants born extremely preterm and weighing <1000 g at birth. TRIAL REGISTRATION http//www.ctri.nic.in (CTRI/2020/01/022  964).
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Recolección de Muestras de Sangre / Transfusión de Eritrocitos / Recien Nacido Extremadamente Prematuro Límite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Recolección de Muestras de Sangre / Transfusión de Eritrocitos / Recien Nacido Extremadamente Prematuro Límite: Female / Humans / Male / Newborn Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article