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#086-090 - Red Blood Cell Transfusions

Hello Friends 🥳

We are back with another week of Neonatology Review podcasts. This week we are discussing Red Blood Cell Transfusions. When did we began transfusing babies? What are the recommendations when it comes to transfusions based on the latest evidence? And we will try answer some burning questions on the topic.

See below the papers we are reviewing this week.

We will be adding papers as we discuss them on the show this week and publish the presentation on friday as usual.

Link to download the PowerPoint and notes from these episodes 👇

Here is the blog post by Dr. Keith Barrington that we discussed on the show and the table summarizing the hematocrit cutoffs of the various transfusion trials:


The articles covered on this series of episodes can be found here 👇

Current practice and guidelines for the transfusion of cellular blood components in the newborn.

Sacher RA, Luban NL, Strauss RG.Transfus Med Rev. 1989 Jan;3(1):39-54. doi: 10.1016/s0887-7963(89)70067-5.PMID: 2520538 Review. No abstract available.

A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group.

Hébert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E.N Engl J Med. 1999 Feb 11;340(6):409-17. doi: 10.1056/NEJM199902113400601.PMID: 9971864 Free article. Clinical Trial.


Randomized trial of liberal versus restrictive guidelines for red blood cell transfusion in preterm infants.

Bell EF, Strauss RG, Widness JA, Mahoney LT, Mock DM, Seward VJ, Cress GA, Johnson KJ, Kromer IJ, Zimmerman MB.Pediatrics. 2005 Jun;115(6):1685-91. doi: 10.1542/peds.2004-1884.PMID: 15930233 Free PMC article. Clinical Trial.


The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants.

Kirpalani H, Whyte RK, Andersen C, Asztalos EV, Heddle N, Blajchman MA, Peliowski A, Rios A, LaCorte M, Connelly R, Barrington K, Roberts RS.J Pediatr. 2006 Sep;149(3):301-307. doi: 10.1016/j.jpeds.2006.05.011.PMID: 16939737 Clinical Trial.

Neurodevelopmental outcome of extremely low birth weight infants randomly assigned to restrictive or liberal hemoglobin thresholds for blood transfusion.

Whyte RK, Kirpalani H, Asztalos EV, Andersen C, Blajchman M, Heddle N, LaCorte M, Robertson CM, Clarke MC, Vincer MJ, Doyle LW, Roberts RS; PINTOS Study Group.Pediatrics. 2009 Jan;123(1):207-13. doi: 10.1542/peds.2008-0338.PMID: 19117884 Clinical Trial.

Effects of Liberal vs Restrictive Transfusion Thresholds on Survival and Neurocognitive Outcomes in Extremely Low-Birth-Weight Infants: The ETTNO Randomized Clinical Trial.

Franz AR, Engel C, Bassler D, Rüdiger M, Thome UH, Maier RF, Krägeloh-Mann I, Kron M, Essers J, Bührer C, Rellensmann G, Rossi R, Bittrich HJ, Roll C, Höhn T, Ehrhardt H, Avenarius S, Körner HT, Stein A, Buxmann H, Vochem M, Poets CF; ETTNO Investigators.JAMA. 2020 Aug 11;324(6):560-570. doi: 10.1001/jama.2020.10690.PMID: 32780138 Free PMC article. Clinical Trial.


Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants.

Kirpalani H, Bell EF, Hintz SR, Tan S, Schmidt B, Chaudhary AS, Johnson KJ, Crawford MM, Newman JE, Vohr BR, Carlo WA, D'Angio CT, Kennedy KA, Ohls RK, Poindexter BB, Schibler K, Whyte RK, Widness JA, Zupancic JAF, Wyckoff MH, Truog WE, Walsh MC, Chock VY, Laptook AR, Sokol GM, Yoder BA, Patel RM, Cotten CM, Carmen MF, Devaskar U, Chawla S, Seabrook R, Higgins RD, Das A; Eunice Kennedy Shriver NICHD Neonatal Research Network.N Engl J Med. 2020 Dec 31;383(27):2639-2651. doi: 10.1056/NEJMoa2020248.PMID: 33382931 Free PMC article. Clinical Trial.


Pathophysiology of Anemia During the Neonatal Period, Including Anemia of Prematurity.

Widness JA.Neoreviews. 2008 Nov 1;9(11):e520. doi: 10.1542/neo.9-11-e520.PMID: 20463861 Free PMC article.


Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants.

Patel RM, Knezevic A, Shenvi N, Hinkes M, Keene S, Roback JD, Easley KA, Josephson CD.JAMA. 2016 Mar 1;315(9):889-97. doi: 10.1001/jama.2016.1204.PMID: 26934258 Free PMC article.

Historical Perspectives: Cured by the Blood: The Story of the First Neonatal Blood Transfusion 
Tonse N. K. Raju, MD, DCH Neoreviews (2006) 7 (2): e67–e68.

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