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Am J Perinatol 2016; 33(11): 1079-1084
DOI: 10.1055/s-0036-1586106
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Transfusion Practice: When do Neonates Need Red Blood Cells or Platelets?

Antonio Del Vecchio
1   Neonatal Intensive Care Unit, Department of Women's and Children's Health, “Di Venere” Hospital, Bari, Italy
,
Caterina Franco
1   Neonatal Intensive Care Unit, Department of Women's and Children's Health, “Di Venere” Hospital, Bari, Italy
,
Flavia Petrillo
1   Neonatal Intensive Care Unit, Department of Women's and Children's Health, “Di Venere” Hospital, Bari, Italy
,
Gabriele D'Amato
1   Neonatal Intensive Care Unit, Department of Women's and Children's Health, “Di Venere” Hospital, Bari, Italy
› Author Affiliations
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Publication History

Publication Date:
07 September 2016 (online)

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Abstract

Based on small studies and not on statistically valid clinical trials, guidelines for neonatal transfusions remain controversial and practices vary greatly. Premature infants and critically ill neonates in the neonatal intensive care unit (NICU) often require blood transfusions and extremely preterm neonates receive at least one red blood cell transfusion during their hospital stay. Transfusions to neonates convey both benefits and risks and consequently it is imperative to establish specific guidelines to improve practice and avoid unnecessary transfusions. Appropriate and lifesaving platelet transfusion in thrombocytopenic bleeding neonates pertains to 2% of all neonates in NICUs. Inversely, 98% of platelet transfusions are given prophylactically, in the absence of bleeding, with the assumption that this reduces the risk of a serious hemorrhage. To date, no evidence base is available for assigning a platelet transfusion trigger to NICU patients. Each NICU should approve specific guidelines that best suit its local clinical practice. Therefore, whatever guidelines are chosen in deciding when to transfuse, what is most important is to adhere strictly to the guidelines adopted, thus limiting unnecessary transfusions that convey no benefits and carry both known and unknown risks.

Keywords

neonatal transfusion - red blood cells - neonatal anemia - thrombocytopenic
 

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