Red Blood Cell Transfusion Practice Pattern Before and After Implementation of a Local Restrictive Transfusion Protocol in a Neonatal Intensive Care Unit

Q4 Medicine Journal of Neonatology Pub Date : 2024-01-23 DOI:10.1177/09732179231220195
Lily Chartrand, Alexandra Zabeid, Jacques Lacroix, A. Villeneuve
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Abstract

A restrictive red blood cell (RBC) transfusion guideline was established in 2019 in a neonatal intensive care unit (NICU), suggesting a hemoglobin concentration threshold of 7 g/dL. (a) To determine its impact on the number of RBC transfusions and donor exposure; (b) to characterize RBC-transfusion determinants and justifications. Single-center retrospective historical control study comparing all neonates consecutively admitted to the NICU during two five-month periods: 401 patients in 2013 before and 402 patients in 2021 after restrictive guideline implementation. Possible determinants were assessed via logistic regressions and justifications via a questionnaire. In 2021, 9.2% of neonates received at least one RBC transfusion compared to 13.5% in 2013 ( p = .075). Adherence to protocol thresholds was 50%. Implementation of a restrictive transfusion protocol had some impact on determinants related to neonatal morbidity and illness severity and some impact on justifications being mainly based on hemoglobin value. Our study demonstrates that the implementation of a restrictive RBC transfusion protocol tended to decrease transfusion rates and donor exposure in the NICU, but the trend was not statistically significant. Future work should focus on improving protocol adherence.
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新生儿重症监护病房实施本地限制性输血协议前后的红细胞输血实践模式
2019 年,新生儿重症监护病房(NICU)制定了限制性红细胞(RBC)输注指南,建议血红蛋白浓度阈值为 7 g/dL。(a) 确定其对红细胞输注数量和供体暴露的影响;(b) 描述红细胞输注的决定因素和理由。单中心回顾性历史对照研究比较了新生儿重症监护室在两个五个月期间连续收治的所有新生儿:2013年限制性指南实施前的401名患者和2021年限制性指南实施后的402名患者。通过逻辑回归对可能的决定因素进行了评估,并通过问卷调查说明了理由。2021年,9.2%的新生儿接受了至少一次RBC输血,而2013年为13.5% ( p = .075)。协议阈值的遵守率为 50%。限制性输血方案的实施对与新生儿发病率和疾病严重程度相关的决定因素有一定影响,对主要基于血红蛋白值的理由也有一定影响。我们的研究表明,实施限制性红细胞输注方案往往会降低新生儿重症监护室的输血率和供体暴露,但这一趋势在统计学上并不显著。今后的工作重点应放在提高方案的依从性上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Neonatology
Journal of Neonatology Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.30
自引率
0.00%
发文量
55
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