PRBC transfusion and preterm

BACKGROUND: Treatment with recombinant human erythropoietin (rHu-EPO) modestly prevented packed red blood cell transfusions (pRBCTs) in preterm infants in studies performed several years ago. In France, some neonatal units stopped using rHu-EPO, while others continued. The aim of this study was to explore the role of rHu-EPO in the prevention of pRBCTs in a recent cohort of preterm infants. MATERIALS AND METHODS: Preterm infants who met rHu-EPO indications and were hospitalised between 2018 and 2020 in two neonatal units-one that did not use rHu-EPO and another that did-were eligible...

BACKGROUND: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness worldwide. Proper screening for ROP can prevent loss of vision. WINROP (weight, insulin-like growth factor 1, neonatal, retinopathy of prematurity) is an online surveillance system based on gestational age, birth weight and weekly weight gain that can predict infants at risk of sight-threatening retinopathy of prematurity. AIMS: To evaluate the diagnostic accuracy of WINROP algorithm in detecting sight-threatening ROP in Egyptian preterm neonates...

BACKGROUND: Since iron is crucial for many tissue processes, we, therefore, aimed to assess ferritin and the zinc protoporphyrin to heme ratio (ZnPP/H) as indicators of iron status in preterm newborns, particularly during certain inflammatory episodes. METHODS: From 170 preterm babies, paired ferritin and ZnPP/H measurements were collected twice (on the first postnatal day and six weeks later). To compare these measures and assess the impact of anemia, sepsis, and packed red blood cell transfusion (PRBT), three different scenarios were considered...

Objective: To examine adverse delivery outcomes from 2018 to 2019 severe maternal morbidity (SMM) cases that were reviewed by facility-level review committees in Illinois ( n  = 666) and describe the burden of adverse delivery outcomes among demographic subgroups, SMM etiology, and whether the SMM event was potentially preventable. Materials and Methods: This is a descriptive analysis of the SMM review cohort. Consistent with expert recommendations to identify SMM for hospital quality review, SMM was defined as any intensive care or critical care unit admission and/or transfusion of four or more units of packed red blood cells from conception to 42 days postpartum...

IMPORTANCE: Repeated transfusions in preterm neonates with anemia of prematurity replace fetal hemoglobin (HbF) with adult Hb (HbA), which has a low oxygen affinity. The reduction of HbF is associated with a higher incidence of retinopathy of prematurity (ROP). OBJECTIVE: To assess whether HbF and HbA are differently associated with cerebral tissue oxygenation in preterm neonates. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a single-center, pilot study on cerebral oxygenation kinetics in preterm neonates with a gestational age between 24...

BACKGROUND: Currently, the treatment of anemia in preterm infants is based on packed red blood cell (RBC) transfusions from adult donors. Oxygen (O2) is mainly transported to the tissues bound to hemoglobin (Hb). In extremely low gestational age neonates (ELGANs), fetal hemoglobin (HbF), which has a higher affinity for O2, represents up to 95% of circulating hemoglobin. During the first month of life, the majority of ELGANs will require an adult-donor RBC transfusion causing HbF levels to rapidly drop...

Background Packed red blood cell (PRBC) transfusions are routine in neonatal care and the most common blood product administered to sick neonates. However, their impact on leukocyte and platelet profiles in very low birth weight (VLBW) preterm infants remains largely unexplored. This study examines leukocyte profile shifts and platelet dynamics following leukoreduced PRBC transfusions in VLBW preterm infants, offering insights to improve neonatal care and reduce unnecessary interventions. Methods The study utilized a retrospective cohort design within a single center, focusing on VLBW preterm infants who received PRBC transfusions at a level 3 NICU between January 2014 and June 2019...

Fetal hemoglobin (HbF) has a higher affinity to oxygen than adult hemoglobin (HbA), allowing for a slower oxygen transfer to peripheral tissue, creating a microenvironment conducive to adequate fetal development in utero. However, most preterm infants receive packed red blood cell transfusions from adult donors leading to a drastic, non-physiological descent of circulating HbF. We hypothesized that this drop could enhance oxygen delivery to peripheral tissues generating a hyperoxic pro-oxidant environment. To investigate this, we assessed differences in oxidative stress biomarkers determined in urine samples in a cohort of 56 preterm infants born below 32 weeks' gestation...

BACKGROUND: Parvovirus is a common childhood infection that could be very dangerous to the fetus, if pregnant women become infected. The spectrum of effects range from pure red blood cell aplasia with hydrops fetalis to meningoencephalitis, with many symptoms in between. Severe anemia in the setting of pure red blood cell aplasia is one of the more common effects that neonatal experience (if infected intrapartum), with the current gold standard treatment being intrauterine or postnatal packed red blood cell (PRBC) transfusions, yet intravenous immunoglobulin (IVIG) may be a superior treatment option...

BACKGROUND: Very preterm infants (less than 32 weeks gestational age) experience acute morbidity during their stay in a neonatal intensive care unit. Because of their prematurity and frequent laboratory testing, they experience anemia, requiring correction with packed red blood cell (PRBC) transfusion(s). PRBC transfusions have been linked to neonatal morbidity, such as necrotizing enterocolitis, but never signs and symptoms of physiological stability. OBJECTIVE: The secondary data analysis aimed to examine very preterm infants' physiological stability before, during, and after PRBC transfusions...

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a leading cause of morbidity and mortality in neonatal intensive care units. Our aim was to evaluate association between packed red blood cell transfusion and the development of BPD in very preterm infants. STUDY DESIGN: This retrospective study of very preterm infants (mean gestational age 27.1 ± 2.4 weeks, birthweight 970 ± 271 g) was conducted at Biruni University (Turkey) between July 2016 and December 2020...

OBJECTIVE: To evaluate the association of donor sex with transfusion-associated recipient immune responses in preterm newborns receiving unwashed and washed blood. DESIGN: A cohort study using data collected during the Effect of Washed versus Unwashed Packed Red Blood Cell Transfusion on Immune Responses in the Extremely Preterm Newborn randomised trial. SETTING: Participants were recruited from two South Australian hospitals between September 2015 and December 2020...

This article presents the near-infrared spectroscopy (NIRS) dataset of cerebral (StO2 c) and splanchnic (StO2 s) oxygenation in 29 stable premature infants admitted to a tertiary neonatal intensive care unit who received elective packed red blood cell transfusion (PRBCT) to treat anemia of prematurity. StO2 c and StO2 s data were prospectively recorded continuously from at least 4 hours before the beginning of PRBCT until 24 hours after its completion, using a 4-wavelength near-infrared spectroscopy (NIRS) monitor (FORE-SIGHT® absolute cerebral oximeter, CASMED, Branford, Connecticut, 06405 USA)...

Volume expanders are indicated in the delivery room when an asphyxiated neonate is not responding to the steps of neonatal resuscitation and has signs of shock or a history of acute blood loss. Fetal blood loss (e.g., feto-maternal hemorrhage) may contribute to perinatal asphyxia. Cord compression or a tight nuchal cord can selectively occlude a thin-walled umbilical vein, resulting in feto-placental transfusion and neonatal hypovolemia. For severe bradycardia or cardiac arrest secondary to fetal blood loss, Neonatal Resuscitation Program (NRP) recommends intravenous volume expanders (crystalloids such as normal saline or packed red blood cells) infused over 5 to 10 min...

BACKGROUND: Plasma is a commonly used blood product and is available in the form of fresh frozen plasma (FFP) or pooled solvent/detergent-treated plasma. In the Netherlands, solvent/detergent-treated plasma has become the standard product in the adult population since several years, but for neonatal use, FFP remains the product of preference. DESCRIPTION: A preterm neonate developed lung bleeding at day 8 postpartum, for which intubation and mechanical ventilation was required and transfusions with packed red blood cells and plasma, in the form of FFP, were given...

BACKGROUND: Splanchnic-cerebral oxygenation ratio (SCOR), the ratio of splanchnic tissue oxygen (StO2 s) to simultaneously measured cerebral tissue oxygen (StO2 c), has been described as a surrogate to detect impaired splanchnic oxygenation associated with hypoperfusion status such as necrotizing enterocolitis. This concept is based on the presumption that any change in SCOR indicates a corresponding change in splanchnic tissue oxygenation as the numerator, whereas cerebral tissue oxygenation as the denominator remains stable...

OBJECTIVES: To evaluate the maternal and neonatal outcomes of expected and unexpected pathologically proven placenta accreta spectrum (PAS) cases in a single multidisciplinary center. MATERIAL AND METHODS: This was a retrospective cohort study of 92 PAS cases from January 2011 until September 2021. Only cases with histopathologically invasive placentation were included in the study. The cases diagnosed at the time of delivery were defined as unexpected PAS (uPAS) and those diagnosed antenatally as expected PAS (ePAS)...

Very low birth weight (VLBW) preterm infants universally experience anemia of prematurity (AOP) while growing up. The effects of reduced blood sample volume on AOP, packed red blood cell (PRBC) transfusion, and outcome in VLBW preterm infants were examined in this study. To reduce blood loss due to phlebotomy, we set up a small volume blood sampling procedure in VLBW infants. In this retrospective study, we compared the VLBW infants who had undergone standard blood sampling (control group, n = 20) with those who underwent small volume blood sampling (study group, n = 84), with both groups receiving PRBC transfusion under restrictive criteria...

Premature infants commonly receive adult packed red blood cells (pRBCs) during their hospital stay. As adult erythrocytes differ substantially from those of preterm infants, transfusion of adult pRBCs into preterm infants can be considered inappropriate for the physiology of a preterm infant. An absence of standardisation of transfusion protocols makes it difficult to compare and interpret pertinent clinical data, as reflected by unclear associations between pRBC transfusion and complications related to prematurity, such as bronchopulmonary dysplasia, neurodevelopmental impairment, retinopathy of prematurity, or necrotising enterocolitis...

BACKGROUND: It is well established that counter-regulation to hypoxia follows a hierarchical pattern, with brain-sparing in preference to peripheral tissues. In contrast, it is unknown if the same hierarchical sequence applies to recovery from hypoxia after correction of anemia with packed red blood cell transfusion (PRBCT). OBJECTIVE: To understand the chronology of cerebral and splanchnic tissue oxygenation resulting after correction of anemia by PRBCT in preterm infants using near-infrared spectroscopy (NIRS)...