Transfused blood age does not impact outcomes in premature babies

By Helen Albert, Senior medwireNews Reporter

Using fresh red blood cells (RBCs) for premature babies who need blood transfusions does not improve outcomes over use of standard blood bank donations, show study findings published in JAMA.

The team observed no differences in the rates of major organ failure, mortality, or infection between babies given "fresh" blood that was 5.1 days old on average over standard blood that was a mean of 14.6 days old.

The results contradict previous held beliefs that fresh blood is better, said lead author Dean Fergusson (Ottawa Hospital Research Institute, Ontario, Canada).

"However, the effect of fresher blood on clinical outcomes had never been examined using a randomized clinical trial in human patients, which is considered the gold standard in medical science," he explained in a press statement.

"Now it has, and we found the standards currently in place are no different for this highly vulnerable population of pre-term infants than a policy and system that would favor fresh blood."

Fergusson and colleagues recruited 377 premature babies with a birthweight of less than 1250 g to take part in their study. The babies were admitted to six Canadian neonatal intensive care units between 2006 and 2011.

The researchers randomly assigned the infants to treatment with RBCs that had been stored for 7 days or less (n=188) with standard blood bank issue older RBCs (n=189).

The primary outcome, measured for the period of stay on the intensive care unit up to 90 days, was a combined measure of neonatal morbidities including necrotizing enterocolitis, retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia, and death. Nosocomial infection was measured as a secondary outcome.

No significant differences between the two groups were seen for the primary outcome, with a rate of 52.7% in the fresh versus 52.9% in the standard RBC group.

Similarly, no differences in the rate of infection were seen, at 77.7% and 77.2% in the fresh and the standard RBC groups, respectively.

"We did not find any clinically meaningful or statistically significant differences and, therefore, the many laboratory changes that occur with prolonged RBC storage may not be as important as once thought," write the authors.

"We thus do not recommend any changes to storage time practices for the provision of RBCs to infants admitted to neonatal intensive care," they conclude.

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