Large-volume transfusions appear to produce a more pronounced improvement in hemoglobin levels and lead to shorter hospital stays in newborns with anemia, including in infants with hemolytic disease of the fetus and newborn (HDFN), according to a recently published study in Transfusion and Apheresis Science.
Anemia is the medical term used to describe a condition in which a person does not have enough red blood cells or hemoglobin to transport oxygen throughout the body. In newborns, anemia can be due to several causes, including HDFN, prematurity and excessive blood sampling.
Newborns with anemia often require blood transfusions to improve red blood cell levels. The optimal dosage for this transfusion expressed in milliliters (ml) per kilogram (kg) of body weight has not yet been determined. Although some studies suggest that administering greater volumes could be beneficial, adverse effects associated with those doses have limited their use.
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The authors aimed to assess the effect of large-volume and low-volume transfusions on the length of an infant’s hospital stay, as well as the number of transfusions, hemoglobin levels and oxygenation levels in the brain and intestines. The study included 78 premature newborns with anemia who received small-volume transfusions and 73 who received large-volume transfusions.
Although there was no significant difference in cerebral and intestinal blood oxygenation, patients who received large-volume transfusions required fewer total transfusions, had shorter hospital stays and saw greater improvement in hemoglobin levels. Furthermore, there was no significant difference in the frequency of transfusion-related complications between both groups.
The results suggest that large-volume transfusions could be a better option than low-volume transfusions as they are associated with more benefits without increasing the risk of adverse effects and complications. However, the authors stated that further research with larger samples is required to determine the safety of large-volume transfusions.
“Further large-scale prospective studies are necessary to determine the long-term benefits, cost-effectiveness, and safety profile of larger-volume transfusion,” the authors wrote.
