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首页> 外文期刊>British Journal of Haematology >The safety and efficacy of red cell transfusions in neonates: A systematic review of randomized controlled trials
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The safety and efficacy of red cell transfusions in neonates: A systematic review of randomized controlled trials

机译：新生儿红细胞输注的安全性和有效性：随机对照试验的系统评价

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Premature neonates commonly receive red blood cell (RBC) transfusions. This study systematically identified and appraised randomized controlled trials (RCTs) where the intervention was 'transfusion of red blood cells' from searches of multiple databases. Primary review outcomes were mortality, neurodevelopmental and respiratory endpoints. Two reviewers extracted data and assigned overall quality. Twenty-seven RCTs were identified and grouped into four predefined categories: trials comparing RBC transfusion versus no transfusion/placebo (n = 3); different thresholds for transfusion (n = 6); differing doses or administration schedule (n = 4), or different types or products of RBC (n = 14). In the threshold group of trials, enrolling 679 neonates, no significant differences in mortality (relative risk 1·22, 95% confidence interval 0·84-1·75) or chronic lung disease were found. Only two trials assessed neurodevelopment outcomes, both within the threshold group, but with differing results. The largest subgroup of RCTs by number evaluated different media for storage of red cells (n = 7), enrolling 221 neonates. The methodological quality of many RCTs was poor. The design of future RCTs can be informed by the lessons from this review. Many trials failed to report on outcomes that would be considered of primary importance to clinicians. Consistent reporting of adverse events is required, and endpoints need to include neurodevelopmental outcomes.
机译：早产新生儿通常接受红细胞（RBC）输血。这项研究系统地确定和评估了随机对照试验（RCT），其中的干预措施是通过多个数据库的搜索来“输血红细胞”。初步审查结果为死亡率，神经发育和呼吸终点。两名审稿人提取了数据并指定了总体质量。确定了27个RCT，并将其分为四个预定类别：比较RBC输血与不输血/安慰剂的试验（n = 3）;不同的输血阈值（n = 6）;不同的剂量或给药方案（n = 4），或不同类型或产品的RBC（n = 14）。在679例新生儿的阈值试验组中，未发现死亡率（相对风险1·22，95％置信区间0·84-1·75）或慢性肺病的显着差异。只有两项试验评估了神经发育结局，均在阈值组内，但结果不同。 RCT的最大亚组数量评估了用于储存红细胞的不同培养基（n = 7），招募了221名新生儿。许多RCT的方法学质量很差。这次审查的教训可以为将来的RCT设计提供参考。许多试验未能报告对临床医生最重要的结果。需要一致报告不良事件，并且终点需要包括神经发育结局。

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