The premature infants in need of transfusion (pint) study: A randomized, controlled trial of a restrictive (LOW) versus liberal (HIGH) transfusion threshold for extremely low birth weight infants - 09/08/11
, Robin K. Whyte, MB, FRCP(C) 1, Chad Andersen, MBBS, FRACP, Elizabeth V. Asztalos, MSc, FRCP(C), Nancy Heddle, MSc, Morris A. Blajchman, MD, FRCP(C), Abraham Peliowski, MD, FRCP(C), Angel Rios, MD, Meena LaCorte, MD, Robert Connelly, MD, FRCP(C), Keith Barrington, MB, FRCP(C), Robin S. Roberts, M.TechPINT Investigators
Reprint requests: Dr Haresh Kirpalani, McMaster University, HSC 3N11F, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.Résumé |
Objective |
To determine whether extremely low birth weight infants (ELBW) transfused at lower hemoglobin thresholds versus higher thresholds have different rates of survival or morbidity at discharge.
Study design |
Infants weighing <1000 g birth weight were randomly assigned within 48 hours of birth to a transfusion algorithm of either low or high hemoglobin transfusion thresholds. The composite primary outcome was death before home discharge or survival with any of either severe retinopathy, bronchopulmonary dysplasia, or brain injury on cranial ultrasound. Morbidity outcomes were assessed, blinded to allocation.
Results |
Four hundred fifty-one infants were randomly assigned to low (n = 223) or high (n = 228) hemoglobin thresholds. Groups were similar, with mean birth weight of 770 g and gestational age of 26 weeks. Fewer infants received one or more transfusions in the low threshold group (89% low versus 95% high, P = .037). Rates of the primary outcome were 74.0% in the low threshold group and 69.7% in the high (P = .25; risk difference, 2.7%; 95% CI –3.7% to 9.2%). There were no statistically significant differences between groups in any secondary outcome.
Conclusions |
In extremely low birth weight infants, maintaining a higher hemoglobin level results in more infants receiving transfusions but confers little evidence of benefit.
Le texte complet de cet article est disponible en PDF.Abbreviations : BPD, ELBW, PINT, RBC, ROP
Plan
| This study was supported by the Canadian Institutes Health Research (FR No. 41549) 2000-2004. Registration Number: www.clinicaltrials.gov NCT 00182390. |
Vol 149 - N° 3
P. 301 - septembre 2006 Retour au numéro
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