Evidence map›Paper›PMID 40435998›Full record

ArticleNeonatology2025

Transfusion Practices in 12 Neonatal Networks: Are We Closer to Adopting a Restrictive Transfusion Approach?

Gil Klinger, Kjell Helenius, Maximo Vento, Satoshi Kusuda, Mikael Norman, Renato Soibelman Procianoy, Neha Goswami, Valerie Biran, Dirk Bassler, Brian Reichman and 11 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Neonatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Gil KlingerDepartment of Neonatal Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Kjell HeleniusDepartment of Pediatrics and Adolescent Medicine, Turku University Hospital, and Department of Clinical Medicine, University of Turku, Turku, Finland.
Maximo VentoNeonatal Research Group, Health Research Institute La Fe (IISLAFE), Valencia, Spain.
Satoshi KusudaNeonatal Research Network of Japan, Kyorin University, Tokyo, Japan.
Mikael NormanDepartment of Neonatal Medicine, Karolinska University Hospital and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Renato Soibelman ProcianoyNewborn Section, Universidade Federal do Rio Grande do Sul (UFRGS) and Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Neha GoswamiDepartment of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.
Valerie BiranService de Pédiatrie et Réanimation Néonatales, Hôpital Universitaire Robert-Debré, Université de Paris-Cité, Paris, France.
Dirk BasslerNewborn Research, Department of Neonatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Brian ReichmanTel Aviv University, Tel Aviv, Israel.
Aleksandra SkubiszDepartment of Neonatology and NICU, Clinical Provincial Hospital No 2, University of Rzeszów, Rzeszow, Poland.
Malcolm BattinNewborn Services, Auckland City Hospital, Auckland, New Zealand.
Liisa LehtonenDepartment of Pediatrics and Adolescent Medicine, Turku University Hospital, and Department of Clinical Medicine, University of Turku, Turku, Finland.
Kei LuiNational Perinatal Epidemiology and Statistics Unit, University of New South Wales, Randwick, New South Wales, Australia.
Annalisa MoriNeonatal Intensive Care Unit, University Hospital of Siena, Siena, Italy.
Marc BeltempoDepartment of Pediatrics, McGill University, Montreal, Québec, Canada.
Mark AdamsNewborn Research, Department of Neonatology, University of Zurich and University Hospital Zurich, Zurich, Switzerland.
Laura San FelicianoUnidad de Neonatología, Hospital Universitario de Salamanca, Salamanca, Spain.
Tetsuya IsayamaDivision of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
Prakesh S ShahDepartment of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.
iNeo Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

<p>Introduction: Recent evidence suggests a restrictive approach toward blood transfusions for management of preterm infants. Objective was to survey blood transfusion practises in preterm neonates <29 weeks' gestation among 12 population-based neonatal networks participating in the International Network for Evaluating Outcomes in Neonates (iNeo).

methodsAn online survey based on 2023 practices was sent to 608 neonatal intensive care units (NICUs): Australia/New Zealand (30), Brazil (20), Canada (32), Finland (5), France (70), Israel (26), Japan (292), Poland (56), Spain (55), Sweden (9), Switzerland (9), and Tuscany, Italy (4). Transfusion thresholds in 4 different scenarios were surveyed: (a) infants invasively ventilated within first 7 postnatal days, (b) infants invasively ventilated after 7 days, (c) stable infants on noninvasive respiratory support, and (d) stable infants requiring no respiratory support.

resultsA total of 382 NICUs (63%) responded. Transfusion practices varied within networks and between countries. For invasively ventilated infants, the transfusion threshold during first 7 days after birth was a hematocrit <underline>≤</underline>35% in 79% of NICUs, and at an age ≥8 days, the transfusion threshold was a hematocrit <underline>≤</underline>30% in 68% of NICUs. For stable infants on noninvasive ventilation, the transfusion threshold was a hematocrit <underline>≤</underline>30% in 80%, and in those without respiratory support, the transfusion threshold was a hematocrit of <underline>≤</underline>25% in 68% of NICUs.

conclusionsVariations exist in blood transfusion practises between countries and within networks. A restrictive transfusion approach based on recent recommendations has been adopted by more than two-thirds of NICUs. Additional research is needed to evaluate whether practices align with intentions and how they impact outcomes. </p>.

Indexed as

Blood TransfusionInfant, PrematureIntensive Care Units, NeonatalPractice Patterns, Physicians'EuropeGestational AgeHealth Care SurveysHematocritHumansInfant, Extremely PrematureInfant, NewbornRespiration, ArtificialSurveys and QuestionnairesBlood transfusionsExtremely preterm infantsTransfusion policy

Identifiers

PMID40435998
PMCPMC12215162

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.