Trial reportArchives of disease in childhood. Fetal and neonatal edition2025
Effects of liberal versus restrictive transfusion strategies on intermittent hypoxaemia in extremely low birthweight infants: secondary analyses of the ETTNO randomised controlled trial.
Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01393496 (Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low Birth Weight Infants), which is not on this map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low Birth Weight Infants (ETTNO)- a Blinded Randomized Controlled Multicenter Trial
Who cites it
3 citing papers in PubMed.
- Short-Term Physiological Effects of Red Blood Cell Transfusion in Very Low Birth Weight Infants: A Retrospective Cohort Study.Children (Basel, Switzerland) · 2026Article
- Oxygen diffusion kinetics, buffering capacity and phenotype: A narrative review of oxygen physiology and later phenotype in very preterm infants.Experimental physiology · 2026Review
- Neonatal blood transfusion practices in India: a nationwide survey of clinicians.Frontiers in pediatrics · 2025Article
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare the effect of liberal versus restrictive transfusion strategies on the proportion of time (%time) spent with intermittent hypoxaemia (IH, ie, arterial haemoglobin oxygen saturation measured by pulse oximetry (SpO DESIGN, SETTING, PATIENTS: Secondary analysis in all 554/1013 infants of <1000 g birth weight recruited into the ETTNO trial (mean gestational age 26.2 weeks) with >80% completeness of SpO
interventionRandomly assigned liberal (n=268) or restrictive (n=286) transfusion strategies, defining transfusion triggers based on postnatal age and health status.
main outcome measures%time with IH, rate and mean duration of IH episodes during postnatal days 8-49. Interaction between exposure to IH and transfusion strategies with respect to ETTNO's composite primary outcome, death or disability at 24 months corrected age.
resultsThe median (quartile 1-quartile 3) %time with IH was similar between treatment groups (0.91% (0.13%-2.83%) with liberal vs 0.79% (0.16%-2.44%) with restrictive transfusions). There was no interaction between exposure to IH and transfusion strategies on outcome at 24 months.
conclusionsIn infants <1000 g birth weight, a liberal transfusion strategy did not reduce IH. Blood transfusions should not be administered 'liberally' to reduce IH or to improve neurocognitive outcome in infants with above-average exposure to IH. TRIAL REGISTRATION NUMBER: NCT01393496.
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