NEJM: Large-scale studies have confirmed that high hemoglobin transfusions have no further benefits for premature children

Babies born with low birth weight are at high risk of anemia and often require blood transfusions to survive.
blood transfusions, some doctors use a higher hemoglobin threshold, while others use a lower hemoglobin threshold.
previous studies have suggested that higher hemoglobin thresholds during red blood cell infusion reduce the risk of cognitive delay in anemic infants with very low birth weight.
recently, researchers from the University of Pennsylvania, the University of Iowa and others collaborated on a paper in the New England Journal of Medicine, NEJM, entitled Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants.
This is by far the largest study to compare blood transfusion thresholds for premature infants, and this large, multicenter randomized clinical trial showed that the application of high hemoglobin thresholds to red blood cell transfusions for very low birth weight infants did not improve survival without neurodevelopmental disorders in premature infants between 22 and 26 months of age.
In this open, multicenter randomized trial, the team recruited 1,824 premature babies with birth weight of less than 1 kg and a gantular age between 22 weeks and 28 weeks and 6 days to receive hemoglobin infusions with higher or lower hemoglobin thresholds within 48 hours of delivery, respectively, until 36 weeks of gergaetic age or discharge, whichever arrived first.
outcomes are a combination of infant death between 22 and 26 months of age or neurodevelopmental disorders (cognitive delay, cerebral palsy, or loss of hearing or vision).
1.9g/dL difference between the two groups in terms of average pre-transfusion hemoglobin levels throughout the treatment period.
1,692 infants (92.8%) in the trial.
of the 845 infants in the higher threshold group, 423 (50.1%) died or survived with neurodevelopmental disorders, while 422 (49.8%) of the 847 infants in the lower threshold group died or survived with neurodevelopmental disorders.
age of 2, the mortality rates of the higher and lower threshold groups (16.2 per cent and 15.0 per cent, respectively) and the rates of neurodevelopmental disorders (39.6 per cent and 40.3 per cent, respectively) were similar.
were discharged from the hospital, the survival rates of no serious complications in the two groups were 28.5% and 30.9%, respectively.
22.7 per cent and 21.7 per cent, respectively.
results showed that the application of higher hemoglobin thresholds failed to improve survival without neurodevelopmental disorders between 22 and 26 months of age during red blood transfusions for very low birth weight children.
the study provided guidance for blood transfusion therapy for these vulnerable premature children, who are light weight, often vulnerable and prone to anaemia.
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