Term umbilical cord blood, fully tested and processed, as the source of red blood cell transfusions for extremely-low-gestational age neonates.

ELGANs (Extremely-Low-Gestational-Age Neonates; those born before 28 weeks gestation) are at risk for developing significant morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and cognitive impairment. The pathogenesis of each of these morbidities is complex, but a growing literature suggests that repeated transfusions of adult donor red blood cells (RBC) conveys a propensity to develop these disorders. The biological rationale for the propensities might vary with each morbidity.

The number of blood transfusions received and the incidence and severity of chronic lung disease among NICU patients born >31 weeks gestation.

Objective: We previously reported the possible pathogenic role, among infants born ≤29 weeks, of transfusions in bronchopulmonary dysplasia. The present study examined this association in infants born >31 weeks.

Study Design: Analysis of red blood cell (RBC) and platelet transfusions in five NICUs to infants born >31 weeks, and chronic neonatal lung disease (CNLD) at six-weeks of age.

Implementing evidence-based restrictive neonatal intensive care unit platelet transfusion guidelines.

Platelet transfusions are life-saving treatments for specific populations of neonates. However, recent evidence indicates that liberal prophylactic platelet transfusion practices cause harm to premature neonates. New efforts to better balance benefits and risks are leading to the adoption of more restrictive platelet transfusion guidelines in neonatal intensive care units (NICU).