Forthcoming Issues
Neonatal Pulmonary Hypertension (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 21, 2023 Category: Perinatology & Neonatology Source Type: research
Understanding the WHEN, WHAT, and WHY of Neonatal Transfusion Medicine
What an exciting time in neonatal transfusion medicine! It has been over 8 years since the last issue of Clinics in Perinatology on neonatal hematology and transfusion medicine was published.1 Much has happened in the intervening years. We are honored to serve as Guest Editors of this exciting issue on Neonatal Transfusion Medicine. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 10, 2023 Category: Perinatology & Neonatology Authors: Ravi Mangal Patel, Amy Keir Tags: Preface Source Type: research
The Future of Transfusion Medicine
Much progress has been made in transfusion medicine since the turn of the nineteenth century when the discovery of blood group antigens made a significant dent in mismatched transfusions and ushered in a new era of science and innovation. Better collection and preservation of blood products, accompanied by accurate testing, tracking, and documentation of essential data, have all essentially reduced transfusion-related errors to a bare minimum. Blood banks now rely on advanced automations and algorithms to manage a wide range of blood products rather than relying on manual records and human judgment. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - October 10, 2023 Category: Perinatology & Neonatology Authors: Lucky Jain Tags: Foreword Source Type: research
Neonatal Blood Banking Practices
There is little formal guidance to direct neonatal blood banking practices and, as a result, practices vary widely across institutions. In this vulnerable patient population with a high transfusion burden, considerations for blood product selection include freshness, extended-storage media, pathogen inactivation, and other modifications. The authors discuss the potential unintended adverse impacts in the neonatal recipient. Concerns such as immunodeficiency, donor exposures, cytomegalovirus transmission, volume overload, transfusion-associated hyperkalemia, and passive hemolysis from ABO incompatibility have driven modific...
Source: Clinics in Perinatology - September 20, 2023 Category: Perinatology & Neonatology Authors: Elizabeth P. Crowe, Ruchika Goel, Nour Al-Mozain, Cassandra D. Josephson Source Type: research
Blood Donor Sex and Outcomes in Transfused Infants
Red blood cell transfusion is common in neonatal intensive care. Multiple trials have evaluated different thresholds for when to administer red blood cell transfusion. In contrast, there has been less focus on studies of the characteristics of red blood cells transfused into neonates. In this review, the authors summarize the emerging literature on the potential impact of the sex of blood donors on outcomes in transfused neonates using a systematic search strategy. The authors review the uncertainty generated from studies with conflicting findings and discuss considerations regarding the impact of blood donor sex and other...
Source: Clinics in Perinatology - September 16, 2023 Category: Perinatology & Neonatology Authors: Anand Salem, Ravi M. Patel Source Type: research
Prophylactic Platelet Transfusions
Preterm neonates are a highly transfused patient group, with platelet transfusions being the second most transfused cellular blood component. Historically, however, evidence to inform optimal platelet transfusion practice has been limited. In pediatrics, much of the evidence has been inferred from studies in adult patients, although neonatologists have generally applied more cautious and liberal platelet transfusion thresholds to mitigate the complications of intraventricular hemorrhage. A total of three randomized controlled trials have now been published comparing different platelet transfusion strategies in neonates. (S...
Source: Clinics in Perinatology - August 31, 2023 Category: Perinatology & Neonatology Authors: Hilde van der Staaij, Simon J. Stanworth, Susanna F. Fustolo-Gunnink Source Type: research
Anemia, Iron Supplementation, and the Brain
The developing brain is particularly vulnerable to extrinsic environmental events such as anemia and iron deficiency during periods of rapid development. Studies of infants with postnatal iron deficiency and iron deficiency anemia clearly demonstrated negative effects on short-term and long-term brain development and function. Randomized interventional trials studied erythropoiesis-stimulating agents and hemoglobin-based red blood cell transfusion thresholds to determine how they affect preterm infant neurodevelopment. Studies of red blood cell transfusion components are limited in preterm neonates. A biomarker strategy me...
Source: Clinics in Perinatology - August 31, 2023 Category: Perinatology & Neonatology Authors: Tate Gisslen, Raghavendra Rao, Michael K. Georgieff Source Type: research
Patient Blood Management in Neonates
Patient blood management (PBM) is an evidence-based care package to improve patient outcomes by optimizing a patient ’s blood, minimizing blood loss, and the effective management and, when appropriate, the tolerance of anemia. It is relatively well-developed in adult medicine and remains in its infancy in neonatology. This review explores why evidence-based guidelines are insufficient, discusses the variations i n neonatal transfusion practice and why this matters, and provides the key updates in neonatal transfusion practice. The authors give examples of a successful neonatal PBM program and single-center projects. (Sou...
Source: Clinics in Perinatology - August 21, 2023 Category: Perinatology & Neonatology Authors: Michelle Chapman, Amy K. Keir Source Type: research
Thresholds for Red Blood Cell Transfusion in Preterm Infants
Rapid blood loss with circulatory shock is dangerous for the preterm infant as cardiac output and oxygen-carrying capacity are simultaneously imperilled. This requires prompt restoration of circulating blood volume with emergency transfusion. It is recommended that clinicians use both clinical and laboratory responses to guide transfusion requirements in this situation. For preterm infants with anemia of prematurity, it is recommended that clinicians use a restrictive algorithm from one of two recently published clinical trials. Transfusion outside these algorithms in very preterm infants is not evidence-based and is activ...
Source: Clinics in Perinatology - August 17, 2023 Category: Perinatology & Neonatology Authors: Chad C. Andersen, Michael J. Stark, Haresh M. Kirpalani Source Type: research
Hemostatic and Immunologic Effects of Platelet Transfusions in Neonates
Liberal platelet transfusions are associated with increased morbidity and mortality among preterm neonates, and it is now recognized that platelets are both hemostatic and immune cells. Neonatal and adult platelets are functionally distinct, and adult platelets have the potential to be more immuno-active. Preclinical studies suggest that platelet transfusions (from adult donors) can trigger dysregulated immune responses in neonates, which might mediate the increased morbidity and mortality observed in clinical studies. More research is needed to understand how neonatal and adult platelets differ in their immune functions a...
Source: Clinics in Perinatology - August 17, 2023 Category: Perinatology & Neonatology Authors: Patricia Davenport, Erin Soule-Albridge, Martha Sola-Visner Source Type: research
Transfusion in Neonatal Extracorporeal Membrane Oxygenation
Extracorporeal Membrane Oxygenation (ECMO) is an important tool for managing critically ill neonates. Bleeding and thrombotic complications are common and significant. An understanding of ECMO physiology, its interactions with the unique neonatal hemostatic pathways, and appreciation for the distinctive risks and benefits of neonatal transfusion as it applies to ECMO are required. Currently, there is variability regarding transfusion practices, related to changing norms and a lack of high-quality literature and trials. This review provides an analysis of the neonatal ECMO transfusion literature and summarizes available bes...
Source: Clinics in Perinatology - August 17, 2023 Category: Perinatology & Neonatology Authors: Goeto Dantes, Sarah Keene Source Type: research
Allogenic Cord Blood Transfusion in Preterm Infants
Repeated red blood cell (RBC) transfusions in preterm neonates cause the progressive displacement of fetal hemoglobin (HbF) by adult hemoglobin. The ensuing increase of oxygen delivery may result at the cellular level in a dangerous condition of hyperoxia, explaining the association between low-HbF levels and retinopathy of prematurity or bronchopulmonary dysplasia. Transfusing preterm neonates with RBC concentrates obtained from allogeneic umbilical blood is a strategy to increase hemoglobin concentration without depleting the physiologic HbF reservoir. This review summarizes the mechanisms underlying a plausible benefici...
Source: Clinics in Perinatology - August 17, 2023 Category: Perinatology & Neonatology Authors: Luciana Teofili, Patrizia Papacci, Carmen Giannantonio, Maria Bianchi, Caterina Giovanna Valentini, Giovanni Vento Source Type: research
Near-Infrared Spectroscopy to Guide and Understand Effects of Red Blood Cell Transfusion
This review is a summary of available evidence regarding the use of near-infrared spectroscopy (NIRS) to help better guide and understand the effects of red blood cell (RBC) transfusion in neonatal patients. We review recent literature demonstrating the changes that take place in regional tissue oxygen saturation (rSO2) resulting from RBC transfusion. We also discuss in detail if any correlation exists between rSO2 and hemoglobin values in neonates. Finally, we review studies that have evaluated the use of NIRS as a transfusion guide during neonatal intensive care. (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 17, 2023 Category: Perinatology & Neonatology Authors: Sean M. Bailey, Pradeep V. Mally Source Type: research
CME Accreditation Page
(Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 2, 2023 Category: Perinatology & Neonatology Source Type: research
Neonatal Nutrition: Evidence-Based Recommendations for Common Conundrums
CLINICS IN PERINATOLOGY (Source: Clinics in Perinatology)
Source: Clinics in Perinatology - August 2, 2023 Category: Perinatology & Neonatology Authors: Brenda B. Poindexter, Amy B. Hair Source Type: research
