TY - JOUR
T1 - Plasma transfusions in neonatal intensive care units
T2 - a prospective observational study
AU - Houben, Nina A M
AU - Fustolo-Gunnink, Suzanne
AU - Fijnvandraat, Karin
AU - Caram-Deelder, Camila
AU - Aguar Carrascosa, Marta
AU - Beuchée, Alain
AU - Brække, Kristin
AU - Cardona, Francesco Stefano
AU - Debeer, Anne
AU - Domingues, Sara
AU - Ghirardello, Stefano
AU - Grizelj, Ruža
AU - Hadžimuratović, Emina
AU - Heiring, Christian
AU - Lozar Krivec, Jana
AU - Maly, Jan
AU - Matasova, Katarina
AU - Moore, Carmel Maria
AU - Muehlbacher, Tobias
AU - Szabo, Miklos
AU - Szczapa, Tomasz
AU - Zaharie, Gabriela
AU - de Jager, Justine
AU - Reibel-Georgi, Nora Johanna
AU - New, Helen V
AU - Stanworth, Simon J
AU - Deschmann, Emöke
AU - Roehr, Charles C
AU - Dame, Christof
AU - le Cessie, Saskia
AU - van der Bom, Johanna G
AU - Lopriore, Enrico
AU - INSPIRE Study Group
N1 - © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
PY - 2025/8/19
Y1 - 2025/8/19
N2 - OBJECTIVE: Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.DESIGN: Prospective observational study.SETTING: 64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.PATIENTS: Preterm infants born below 32 weeks of gestational age.INTERVENTIONS: Admission to the NICU.MAIN OUTCOME MEASURES: Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.RESULTS: A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5-30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).CONCLUSIONS: We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.TRIAL REGISTRATION NUMBER: ISRCTN17267090.
AB - OBJECTIVE: Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.DESIGN: Prospective observational study.SETTING: 64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.PATIENTS: Preterm infants born below 32 weeks of gestational age.INTERVENTIONS: Admission to the NICU.MAIN OUTCOME MEASURES: Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.RESULTS: A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5-30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).CONCLUSIONS: We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.TRIAL REGISTRATION NUMBER: ISRCTN17267090.
KW - Blood Component Transfusion/statistics & numerical data
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Infant, Premature
KW - Intensive Care Units, Neonatal/statistics & numerical data
KW - Male
KW - Plasma
KW - Prospective Studies
KW - Neonatology
KW - Epidemiology
KW - Intensive Care Units, Neonatal
UR - https://www.scopus.com/pages/publications/85216079362
U2 - 10.1136/archdischild-2024-327926
DO - 10.1136/archdischild-2024-327926
M3 - Journal article
C2 - 39832820
SN - 1359-2998
VL - 110
SP - 452
EP - 459
JO - Archives of Disease in Childhood. Fetal and Neonatal Edition
JF - Archives of Disease in Childhood. Fetal and Neonatal Edition
IS - 5
ER -