Plasma transfusions in neonatal intensive care units: a prospective observational study.
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Houben Nina A M, Fustolo-Gunnink Suzanne, Fijnvandraat Karin, Caram-Deelder Camila, Aguar Carrascosa Marta, Beuchée Alain, Brække Kristin, Cardona Francesco Stefano, Debeer Anne, Domingues Sara, Ghirardello Stefano, Grizelj Ruža, Hadžimuratović Emina, Heiring Christian, Lozar Krivec Jana, Maly Jan, Matasova Katarina, Moore Carmel Maria, Muehlbacher Tobias, Szabo Miklos, Szczapa Tomasz, Zaharie Gabriela, de Jager Justine, Reibel-Georgi Nora Johanna, New Helen V, Stanworth Simon J, Deschmann Emöke, Roehr Charles C, Dame Christof, le Cessie Saskia, van der Bom Johanna G, Lopriore Enrico, INSPIRE Study Group
Аннотация
DESIGN: Prospective observational study.
SETTING: 64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.
PATIENTS: Preterm infants born below 32 weeks of gestational age.
INTERVENTIONS: Admission to the NICU.
MAIN OUTCOME MEASURES: Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.
RESULTS: A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5-30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).
CONCLUSIONS: We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.
TRIAL REGISTRATION NUMBER: ISRCTN17267090.