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首页> 外文期刊>BMC Pediatrics >Long-term outcome in relationship to neonatal transfusion volume in extremely premature infants: a comparative cohort study
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Long-term outcome in relationship to neonatal transfusion volume in extremely premature infants: a comparative cohort study

机译：与极早产儿新生儿输血量相关的长期结果：一项比较队列研究

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Background In premature born infants red blood cell (RBC) transfusions have been associated with both beneficial and detrimental sequels. Upon RBC transfusion, improvement in cerebral blood flow and oxygenation have been observed, while a more liberal transfusion policy may be associated with a better developmental outcome. The effect of the transfusion volume on long-term outcome is not known. Methods Observational follow-up study of a cohort of extremely premature born infants, treated in 2 neonatal intensive care units using a different transfusion volume (15 ml/kg in Unit A and 20 ml/kg in Unit B). The primary outcome was a composite of post discharge mortality, neuromotor developmental delay, blindness or deafness, evaluated at a mean corrected age (CA) of 24 months related to the transfusion volume/kg bodyweight administered during the postnatal hospital stay. Results Despite the difference in transfusion volume in clinically comparable groups of infants, they received a similar number of transfusions (5.5 ± 3.2 versus 5.5 ± 2.3 respectively in Unit A and B). The total transfused volume in unit A was 79 ± 47 ml/kg and 108 ± 47 ml/kg in unit B (p = 0.02). Total transfused RBC volume per kg bodyweight was not an independent predictor of the composite outcome (p = 0.96, OR 1.0 (CI 0.9-1.1). Conclusion There was no relationship between the composite outcome at 24 months CA and transfusion volume received during the post natal hospital stay. As there was no clinical advantage of the higher transfusion volume, a more restrictive volume will reduce total transfusion volume and donor exposure. Future research on the optimal transfusion volume per event to extreme preterm infants should include larger, prospective studies with a longer follow-up period through to childhood or even adolescence.
机译：背景技术在早产儿中，红细胞（RBC）的输注与有益和有害的后遗症有关。在进行RBC输血时，已观察到脑血流量和氧合的改善，而更宽松的输血策略可能与更好的发育结果相关。输血量对长期预后的影响尚不清楚。方法对一组2个新生儿重症监护病房使用不同输注量（A单元为15 ml / kg，B单元为20 ml / kg）进行治疗的一组极早产婴儿的观察性随访研究。主要结局是出院后死亡率，神经运动发育延迟，失明或耳聋的综合结果，在产后住院期间的平均校正年龄（CA）为24个月时评估，与输血量/千克体重有关。结果尽管临床上可比较的婴儿组输血量有所不同，但他们接受的输血次数相似（A组和B组分别为5.5±3.2和5.5±2.3）。 A单位的总输注量为79±47 ml / kg，B单位为108±47 ml / kg（p = 0.02）。每千克体重的总输注RBC量不是复合结局的独立预测因子（p = 0.96，OR 1.0（CI 0.9-1.1）。结论结论24个月CA的复合结局与术后输注量之间没有关系由于较高的输血量没有临床优势，因此限制输液量会减少总输血量和供体暴露，关于极端早产儿每次事件的最佳输血量的未来研究应包括较大的前瞻性研究较长的随访期直至儿童期甚至青春期。

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