Predicting red blood cell transfusions in very low birth weight infants based on clinical risk factors.

OBJECTIVE To describe the clinical factors most predictive of red blood cell transfusion in very low birth weight (VLBW) infants. STUDY DESIGN Retrospective review of VLBW infants cared for at a single level III NICU during a two year period, n = 199. RESULTS Overall transfusion requirement was 4.6 +/- 6.2 transfusions/infant/hospital course. Length of hospital stay, days of mechanical ventilation, requirement for dopamine support, birth weight, initial hematocrit, periventricular leukomalacia and necrotizing enterocolitis all independently correlated with number of transfusions and donors. Bronchopulmonary dysplasia and patent ductus arteriosus were associated with donor but not transfusion number. CONCLUSIONS Our data characterize the population of VLBW infants with the greatest blood transfusion and donor requirement. Further investigation is needed to target this population for interventions to reduce blood exposure.