Strict red blood cell transfusion guideline reduces the need for transfusions in very-low-birthweight infants in the first 4 weeks of life: a multicentre trial

Vox Sang. 2005 Feb;88(2):107-13. doi: 10.1111/j.1423-0410.2005.00607.x.


Background and objectives: Very-low-birthweight infants are among the most heavily transfused patients. The objective of this study was to verify if the introduction of a strict guideline would reduce the need for red blood cell transfusions in the first 4 weeks of life in these neonates.

Materials and methods: This was a multicentre prospective study of two cohorts of very-low-birthweight infants transfused in accordance with the recommendations of a neonatologist (Phase 1) or according to previously published guidelines (Phase 2).

Results: In the first 28 days of life, 102 patients (68.5%) in Phase 1 and 117 (59.7%) in Phase 2 were transfused. The number of transfusions was 1.9 +/- 2.0 in Phase 1 and 1.4 +/- 1.6 in Phase 2 (P = 0.01). After adjusting for gestational age, blood loss and the presence of respiratory distress syndrome, the strict guideline reduced the number of transfusions in 17.6% (IC 95%-30.5% to -2.6%).

Conclusions: The strict guideline was effective in reducing erythrocyte transfusions in very-low-birthweight infants.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Blood Volume
  • Cohort Studies
  • Erythrocyte Transfusion / statistics & numerical data*
  • Gestational Age
  • Hematocrit
  • Hemoglobins / analysis
  • Hospitalization
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight / blood*
  • Practice Guidelines as Topic*
  • Premature Birth / blood


  • Hemoglobins