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Instituting a program to reduce the erythrocyte transfusion rate was accompanied by reductions in the incidence of bronchopulmonary dysplasia, retinopathy of prematurity and necrotizing enterocolitis.

Abstract
Bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) all likely involve oxidative damage to immature tissues. It has been postulated that transfusions of adult erythrocytes contribute to the risk of developing these morbidities, as a consequence of adult hemoglobin releasing non-physiological quantities of O₂ to developing tissues. In 2009, we instituted a concerted effort to diminish erythrocyte transfusions in our NICU, and in 2013 we performed a before vs. after practice change analysis of the incidence of BPD, ROP and NEC during the 8-year period spanning this change. The transfusion rate fell from a high of 14.8% of admissions in 2007 to a low of 6.3% in 2011 (p < 0.001). Concordant with this reduction patients had a lower incidence of; BPD (from 3.2% to 0.9%; OR, 3.722; CI 1.897-7.302), ROP (from 4.6% to 2.4%; OR 1.958, CI 1.247-3.073), and a trend toward less NEC (from 0.7% to 0.2%; OR 3.090, CI 0.835-11.443).
AuthorsAntonio Del Vecchio, Erick Henry, Gabriele D'Amato, Annamaria Cannuscio, Luigi Corriero, Mario Motta, Robert D Christensen
JournalThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 26 Suppl 2 Pg. 77-9 (Oct 2013) ISSN: 1476-4954 [Electronic] England
PMID24059559 (Publication Type: Journal Article)
Topics
  • Bronchopulmonary Dysplasia (epidemiology, etiology)
  • Enterocolitis, Necrotizing (epidemiology, etiology)
  • Erythrocyte Transfusion (adverse effects, standards, statistics & numerical data)
  • Guidelines as Topic
  • Health Plan Implementation
  • Humans
  • Incidence
  • Infant, Newborn
  • Intensive Care Units, Neonatal (standards)
  • Italy
  • Retinopathy of Prematurity (epidemiology, etiology)
  • Retrospective Studies

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