Published online September 30, 2005
PEDIATRICS Vol. 116 No. 4 October 2005, pp. 1048-1049 (doi:10.1542/peds.2005-1581)
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Right arrow Premature & Newborn

Randomized Trial of Liberal Versus Restrictive Guidelines for Red Blood Cell Transfusion in Preterm Infants

R. Frederick Boedy, MD
Oommen P. Mathew, MD
Section of Neonatology,
Medical College of Georgia,
Augusta, GA 30912

The first 20% of the full text of this article appears below.

To the Editor.—

We congratulate Bell et al1 for undertaking this difficult but important clinical study. They conclude that their "finding of more frequent adverse neurologic events in the restrictive RBC [red blood cell]-transfusion group suggests that the practice of restrictive transfusions may be harmful to preterm infants." The real question is whether such a conclusion causally linking the transfusion practices to the adverse neurologic outcome can be reached on the basis of the data presented in the article.

The major difference in transfusion practices among neonatologists is not in the acutely sick, ventilator-dependent, very low birth weight infants in the first 2 weeks of life. The difficult question facing them is when to transfuse a growing low birth weight infant with chronic anemia who may or may not be symptomatic. In this regard, the data that are not presented may be more meaningful in helping the readers to decide whether the restrictive practices are harmful to preterm infants.

Almost all intracranial hemorrhage . . . [Full Text of this Article]




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R. K. Ohls
Transfusions in the Preterm Infant
NeoReviews, September 1, 2007; 8(9): e377 - e386.
[Abstract] [Full Text] [PDF]