A randomized clinical trial lead by researchers of George Mason University has examined the blood transfusions in untimely babies and their long term impacts.
The study appears in ‘The New England Publication of Medicine’ and is the largest study to-date to compare thresholds for blood transfusions in untimely infants.
Very low birth weight infants are at high risk for anaemia and ceaselessly need blood transfusions to live on. Some doctors use a higher level and a few use a lower level of red blood cells to order a transfusion. A National Institutes of Health-funded study suggests that providing a higher threshold of red cells inside clinically accepted limits (i.e., the use of a higher level of red blood cells when ordering a transfusion) offers no virtue in survival or discount in neurological impairment over a lower threshold.
Very preterm infants (born before 29 weeks of pregnancy) and those weighing less than 1,000 grams (rather more than 2 pounds) are at high risk for anaemia as a result of their early stage of development, reduced ability to produce red blood cells, and need for blood sampling as a part of their intensive medical care.
Preceding studies propose that anaemic infants who received transfusions at a higher haemoglobin threshold inside the currently accepted range would have a lower risk of death or developmental problems. Measuring haemoglobin, a protein produced in red blood cells, indicates the proportion of red blood cells. Haemoglobin transfusion thresholds for preterm infants differ according to weight, stage of maturity and other factors.
Of 845 infants assigned to a higher haemoglobin threshold, 50.1% died or survived with neurodevelopmental impairment, in comparison to 49.8% of 847 infants assigned to a lower threshold. When the two-component outcomes were evaluated one at a time, the two groups also had similar rates of death (16.2% vs. 15%) and of neurodevelopmental impairment (39.6% vs 40.3%).
The authors evaluated the babies at two years of age and conclude that a higher haemoglobin threshold increased the number of transfusions, but did not give a boost to the chance of survival without neurodevelopmental impairment.
“The findings are likely for use to guide transfusion practice someday for these infants; studies in untimely infants are needed to guide take care of these small and vulnerable infants; studies funded by NIH in multi-site networks are vitally important to the health of these delicate babies,” explains Higgins.
(This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.)
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