Transfusion Thresholds for Extremely Preterm Infants: Higher Is Not Better

Liberal and restrictive hemoglobin thresholds for transfusion of red blood cells in extremely preterm infants result in similar rates of survival or disability.

While most extremely premature infants receive blood transfusions during their initial hospitalization, the lack of a strong evidence base has led to large variations in hematocrit thresholds. A previous study suggested that use of higher hemoglobin thresholds for transfusion may be beneficial for long-term neurocognitive outcomes (Pediatrics 2009; 123:207).

In the current study, from 2011 to 2014, researchers randomized 1013 extremely preterm infants (median gestational age, 26 weeks, 3 days) at 36 European centers to liberal or restrictive transfusion thresholds. Exact hematocrit thresholds were adjusted according to each infant's age and degree of critical illness. As expected, the transfusion volume was higher in the liberal threshold gr…

Reviewing Author

Robin H. Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin H. Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Transfusion Thresholds for Extremely Preterm Infants: Higher Is Not Better

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Reviewing Author