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Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2019.00990    [Accepted]
Published online November 11, 2019.
Red blood cell transfusion and short-term outcomes in very low birth weight infants
Eui Young Lee  , Sung Shin Kim  , Ga Young Park  , Sun Hyang Lee 
Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Correspondence: 
Sung Shin Kim, Tel: +82-32-621-5420, Fax: +82-32-621-5662, Email: sungshin1201@gmail.com
Received: 19 August 2019   • Revised: 8 November 2019   • Accepted: 8 November 2019
Abstract
Background
Red blood cell (RBC) transfusion is known to improve cardiorespiratory status by increasing circulating hemoglobin, improving tissue oxygenation, and reducing cardiac output in preterm infants. However, RBC transfusion itself has also been suggested as an independent factor that negatively affects short-term outcomes such as intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in premature infants.
Purpose
This study aimed to analyze the relationship between RBC transfusion and short-term outcomes in very low birth weight (VLBW) infants (birth weight <1,500 g).
Methods
We retrospectively reviewed medical records of VLBW infants who had been admitted to Soonchunhyang University Bucheon Hospital between October 2010 and December 2017. Infants who died during the hospitalization were excluded. The selected infants were divided into two groups according to RBC transfusion status. We investigated the relationship between RBC transfusion and short-term outcomes including BPD, ROP, NEC, IVH.
Results
250 VLBW infants were enrolled and 109 (43.6%) infants were transfused. Univariate analysis revealed that all short-term outcomes except early onset sepsis and patent ductus arteriosus were associated with RBC transfusion. In multivariate analysis adjusting for gestational age, birth weight and Apgar score at 1 minute, RBC transfusion is significantly correlated with BPD and NEC (BPD [odds ratio (OR), 5.42; P < 0.001], NEC [OR, 3.40; P = 0.009]).
Conclusion
RBC transfusion is significantly associated with adverse clinical outcomes such as NEC and BPD in VLBW infants. Careful consideration of the patient’s clinical condition and appropriate guidelines is required before administering RBC transfusions.
Key Words: Erythrocyte transfusion, Infant, Very low birth weight, Bronchopulmonary dysplasia, Enterocolitis, Necrotizing, Infant, Premature




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