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TRANSFUSION PATTERN OF VERY LOW BIRTH WEIGHT INFANTS (<1250 GRAMS): BEFORE TRANSFUSION GUIDELINES. 1127

Preterm infants are given multiple transfusions during their stay in the NICU, either for the replacement of phlebotomy loss in the first few weeks of life or later for symptomatic anemia of prematurity. Surfactant therapy, limitation of blood loss and conservative transfusion practices have helped to decrease the amount of transfusions, but still around 50 percent of preterm infants with birth weight less than 1500 grams, need multiple transfusions. A historical cohort study was designed to determine the transfusion pattern of preterm infants with birthweight <1250 grams and gestational age <32 weeks, before the implementation of transfusion guidelines (Jul-Dec“94). Blood transfusions were given empirically at the discretion of the attending neonatologist during this period. Of the 56 infants who met the entry criteria, 12 infants were excluded because of perinatal deaths, 5 because of delayed transfer from the referring hospitals. The final cohort consisted of 39 infants. During the study period, the 39 infants received a total of 411 transfusions, with an average of 10.5 transfusions per infant prior to discharge. One-third of the mean volume of blood (52 of 156 ml) was given within the first two weeks of life. The amount transfused in the first two weeks approximated the phlebotomy loss of infants sustained prior to day 14. When the infants were categorized by birth weight, transfusion volume was observed to be two-fold greater in the <1000 gram infants.Table