There is no benefit to raising the red blood threshold for transfusions to very low birthweight babies, according to an analysis published last night.
These babies, who are born before 29 weeks of pregnancy and/or weigh less than 1,000 grams, have a raised risk of mortality or neurological impairment due to anaemia and a reduced ability to produce red blood cells.
For many years, researchers have looked into the possibility of providing them with greater haemoglobin levels than currently recommended, in an attempt to improve their outcomes, according to the US research team.
A new study has been carried out by Dr Haresh Kirpalani of the University of Pennsylvania, USA, and colleagues. They gave 845 very low birthweight infants an increased haemoglobin target following blood transfusions.
Among this group of babies, 50.1% died or survived with a neurodevelopmental impairment. For a separate group of 847 similar babies kept at the standard haemoglobin level, 49.8% died or had a neurodevelopmental impairment.
Looked at separately, death rates in the high haemoglobin group were 16.2% versus 15% in the standard haemoglobin group, and rates of neurodevelopmental impairment were 39.6% in the high haemoglobin group versus 40.3%.
The research appears in the New England Journal of Medicine today (30 December).
Dr Kirpalani says: “Providing a higher threshold of red cells within accepted limits offers no advantage in survival or reduction in neurological impairment over a lower threshold.”
Kirpalani, H. et al. High or low hemoglobin transfusion thresholds for preterm infants. New England Journal of Medicine 30 December 2020.
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