Brazilian Network on Neonatal Research members are listed in the Appendix.
Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units
Version of Record online: 26 AUG 2009
© 2009 American Association of Blood Banks
Volume 50, Issue 1, pages 150–159, January 2010
How to Cite
Dos Santos, A. M.N., Guinsburg, R., Procianoy, R. S., Sadeck, L. d. S. R., Netto, A. A., Rugolo, L. M., Luz, J. H., Bomfim, O., Martinez, F. E. and De Almeida, M. F. B. (2010), Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units. Transfusion, 50: 150–159. doi: 10.1111/j.1537-2995.2009.02373.x
- Issue online: 28 DEC 2009
- Version of Record online: 26 AUG 2009
- Received for publication March 18, 2009; revision received June 20, 2009, and accepted June 21, 2009.
BACKGROUND: Guidelines for red blood cell (RBC) transfusions exist; however, transfusion practices vary among centers. This study aimed to analyze transfusion practices and the impact of patients and institutional characteristics on the indications of RBC transfusions in preterm infants.
STUDY DESIGN AND METHODS: RBC transfusion practices were investigated in a multicenter prospective cohort of preterm infants with a birth weight of less than 1500 g born at eight public university neonatal intensive care units of the Brazilian Network on Neonatal Research. Variables associated with any RBC transfusions were analyzed by logistic regression analysis.
RESULTS: Of 952 very-low-birth-weight infants, 532 (55.9%) received at least one RBC transfusion. The percentages of transfused neonates were 48.9, 54.5, 56.0, 61.2, 56.3, 47.8, 75.4, and 44.7%, respectively, for Centers 1 through 8. The number of transfusions during the first 28 days of life was higher in Center 4 and 7 than in other centers. After 28 days, the number of transfusions decreased, except for Center 7. Multivariate logistic regression analysis showed higher likelihood of transfusion in infants with late onset sepsis (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8-4.4), intraventricular hemorrhage (OR, 9.4; 95% CI, 3.3-26.8), intubation at birth (OR, 1.7; 95% CI, 1.0-2.8), need for umbilical catheter (OR, 2.4; 95% CI, 1.3-4.4), days on mechanical ventilation (OR, 1.1; 95% CI, 1.0-1.2), oxygen therapy (OR, 1.1; 95% CI, 1.0-1.1), parenteral nutrition (OR, 1.1; 95% CI, 1.0-1.1), and birth center (p < 0.001).
CONCLUSIONS: The need of RBC transfusions in very-low-birth-weight preterm infants was associated with clinical conditions and birth center. The distribution of the number of transfusions during hospital stay may be used as a measure of neonatal care quality.