Impact of transfusion guidelines on neonatal transfusions.
Impact of transfusion guidelines on neonatal transfusions.
复制标题
输血指南对新生儿输血的影响。
DOI：
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发表时间：
1998
影响因子：
2.9
通讯作者：
Michael H. Malloy
中科院分区：
文献类型：
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作者：
Alagappan Alagappan;Karen E. Shattuck;Michael H. Malloy
背景
出生体重 (BW) <1250 克的早产儿需要多次输血，以补充失血或纠正早产儿症状性贫血。
目标
评估输血指南在减少体重 <1250 克婴儿输血次数方面的有效性。
方法
这项队列研究是在提供三级产科和新生儿服务的地区教学医疗中心进行的。体重<1250克、胎龄<32周的早产儿在输血指南实施前后6个月期间入住新生儿重症监护病房。最终样本量包括 39 名接受指南前的婴儿 (BG) 和 41 名接受指南后的婴儿 (AG)。主要结局指标是每个婴儿在出生后 2 周内以及出院前的输血总数和输血量。
结果
我们观察到，在生命的前 2 周内，每个婴儿的平均输血次数（4.7 至 2.7，p = 0.003）和输血量（52 ml 至 30 ml，p = 0.0005）显着减少，并且输血总数（10.5 至 8.0，p = 0.08）和输血量（156 ml 至 119 ml，p = BG 与 AG 的出院前输血次数分别为 0.07)。当对 AG 组 41 名婴儿的所有输血是否符合指南进行分析时，发现 96%（328 名婴儿中的 313 名）符合指南。
结论
这项研究表明，输血指南可有效减少体重<1250 克婴儿的输血次数。指南有助于减少输血次数的间接好处可能是提高减少失血的意识。
BACKGROUND
Preterm infants with birth weights (BW) <1250 gm are given multiple blood transfusions either for replacement of blood loss or for correction of symptomatic anemia of prematurity.
OBJECTIVE
To assess the effectiveness of transfusion guidelines in reducing the number of transfusions given to infants with BW <1250 gm.
METHODS
This cohort study was conducted at the regional teaching medical center with level III obstetric and neonatal services. Preterm infants with BW <1250 gm and gestational age <32 weeks were admitted to the neonatal intensive care unit during a period of 6 months before and after implementation of transfusion guidelines. The final sample size constituted 39 infants before guidelines (BG) and 41 infants after guidelines (AG). The primary outcome measure was the total number and volume of transfusions given per infant in the first 2 weeks of life and before discharge from the nursery.
RESULTS
We observed a significant reduction in the mean number (4.7 to 2.7, p = 0.003) and volume (52 ml to 30 ml, p = 0.0005) of transfusions given per infant in the first 2 weeks of life, as well as a definite trend toward reduction in the total number (10.5 to 8.0, p = 0.08) and volume (156 ml to 119 ml, p = 0.07) of transfusions given before discharge in the BG versus AG, respectively. When all the transfusions given to the 41 infants in the AG group were analyzed for compliance with guidelines, 96% (313 of 328) were observed to be in compliance.
CONCLUSION
This study shows that transfusion guidelines are effective in decreasing the number of transfusion given to infants with BW <1250 gm. An indirect benefit of guidelines contributing to a reduced number of transfusions may be a heightened awareness to decrease blood losses.