International Neonatal tranSfusion PoInt pREvalence Study

Organisation: Neonatal Transfusion Network (www.neonataltransfusionnetwork.com)

Lead researchers:

Nina Houben, PhD student. Sanquin Blood Supply Foundation and Leiden University Medical Center

Suzanne Fustolo-Gunnink, MD PhD, clinical epidemiologist. Sanquin Blood Supply Foundation, leiden University Medical Center and Amsterdam University Medical Center.

Enrico Lopriore, professor in neonatology, Leiden University Medical Center

Karin Fijnvandraat, professor in Pediatric Hematology, Amsterdam University Medical Center

Grant amount: 30.000

About

Neonates (newborn babies) are a highly transfused group, but robust evidence supporting transfusion practice is lacking, with significant variation in patterns of use as a result. Recent trials indicate little benefit from transfusing at liberal thresholds and in some cases even report evidence of harm. We aim to perform a point prevalence study to describe prevalence, indications, and component specifications of transfusions among preterm neonates in Europe. This will be the first Europe-wide study to generate neonatal transfusion benchmark data for all participating EBA members. It will highlight areas to improve practice and inform research gaps, while contributing to developing European neonatal transfusion guidelines, the design of new research studies, and a review of  component specifications for neonates to match recipient needs.

Project Aims

To describe the prevalence, indications, and component specifications of transfusions among preterm neonates admitted to neonatal intensive care units in Europe.

Primary outcome: Prevalence of RBC, platelet and plasma (FFP and cryoprecipitate) transfusions in neonates with a gestational age less than 32 weeks at birth admitted to a tertiary level NICU.

Secondary outcomes: Variation of prevalence, indications and appropriateness of use as defined by recommendations in guidelines and a description of component specifications of RBC, platelet and plasma transfusions in neonates with a gestational age less than 32 weeks at birth in tertiary level NICUs in Europe. Outcomes

Project deliverables

We will describe prevalence, indications and component specifications of red blood cell, platelet and plasma transfusions. This will allow us to identify suboptimal practices that can be improved, by comparing practices to existing guidelines and literature. It will also allow us to identify areas with substantial clinical variation, which could be targeted in future clinical studies. All participating centers will receive their own benchmark data as compared to the overall results, to help them improve practice where necessary. Moreover, as this point prevalence study will establish a reference for neonatal transfusion practice within Europe, future studies can evaluate the effect of implemented quality improvement interventions by performing new point prevalence studies using the existing framework, network and protocols. Reduction of unnecessary transfusions may result in better outcomes, lower risk of adverse events, lower costs and better allocation of donor blood.

Related resources: 

https://neonataltransfusionnetwork.com/inspire-study/

https://fn.bmj.com/content/early/2023/01/18/archdischild-2022-324619.long