A practical guide to reducing/eliminating red blood cell transfusions in the neonatal intensive care unit.

Autor: Ohls RK; Division of Neonatology, Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA. Electronic address: robin.ohls@hsc.utah.edu., Bahr TM; Division of Neonatology, Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA; Women and Newborns Research, Intermountain Health, Murray, UT, USA., Peterson TG; NICU Pharmacy, University of Utah Hospital, Salt Lake City, UT, USA., Christensen RD; Division of Neonatology, Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA; Women and Newborns Research, Intermountain Health, Murray, UT, USA.
Jazyk: angličtina
Zdroj: Seminars in fetal & neonatal medicine [Semin Fetal Neonatal Med] 2024 Oct 22, pp. 101545. Date of Electronic Publication: 2024 Oct 22.
DOI: 10.1016/j.siny.2024.101545
Abstrakt: Red blood cell transfusions can be lifesaving for neonates with severe anemia or acute massive hemorrhage. However, it is imperative to understand that red cell transfusions convey unique and significant risks for neonates. The extremely rare risks of transmitting a viral, bacterial, or other microbial infection, or causing circulatory overload are well known and are part of blood transfusion informed consent. Less well known, and not always part of the consent process, are more common risks of transfusing the smallest and most immature NICU patients; specifically, multiple transfusions may worsen inflammatory conditions (particularly pulmonary inflammation), and in certain subsets are associated with retinopathy of prematurity and neurodevelopmental delay. Instituting non-pharmacological transfusion-avoidance techniques reduces transfusion rates. Pharmacological transfusion-avoidance, specifically erythropoietic stimulating agents, further reduces the risk of needing a transfusion. The protocols described herein constitute an efficient and cost-effective transfusion-avoidance program. Using these protocols, many NICU patients can remain transfusion-free.
Competing Interests: Declaration of competing interest The authors have no conflicting interests to declare.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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