{
  "abstract": "Objective Despite lack of evidence supporting efficacy, prophylactic fresh frozen plasma and Octaplas transfusions may be administered to very preterm infants to reduce bleeding risk. International variation in plasma transfusion practices in neonatal intensive care units (NICUs) is poorly understood, therefore, we aimed to describe neonatal plasma transfusion practice in Europe.Design Prospective observational study.Setting 64 NICUs in 22 European countries, with a 6-week study period per centre between September 2022 and August 2023.Patients Preterm infants born below 32 weeks of gestational age.Interventions Admission to the NICU.Main outcome measures Plasma transfusion prevalence, cumulative incidence, indications, transfusion volumes and infusion rates and adverse effects.Results A total of 92 of 1143 infants included (8.0%) received plasma during the study period, collectively receiving 177 transfusions. Overall prevalence was 0.3 plasma transfusion days per 100 admission days, and rates varied substantially across Europe. By day 28 of life, 13.5% (95% CI 10.0% to 16.9%) of infants received at least one plasma transfusion, accounted for competing risks of death or discharge. Transfusions were given for a broad range of indications, including active bleeding (29.4%), abnormal coagulation screen results (23.7%) and volume replacement/hypotension (21.5%). Transfusion volumes and infusion rates varied significantly; the most common volume was 15 mL/kg (range: 5–30 mL/kg) and the most common duration was 2 hours (range: 30 min to 6 hours).Conclusions We found wide variation in plasma transfusion practices in Europe, highlighting the need for evidence to inform neonatologists in daily practice and guidelines, in particular for non-bleeding indications.Trial registration number ISRCTN17267090.",
  "authors": [
    {
      "affiliations": [
        "Sanquin Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands",
        "Division of Neonatology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Nina A M Houben"
    },
    {
      "affiliations": [
        "Sanquin Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands",
        "Division of Neonatology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands",
        "Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC Locatie AMC, University of Amsterdam, Amsterdam, The Netherlands"
      ],
      "name": "Suzanne Fustolo-Gunnink"
    },
    {
      "affiliations": [
        "Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC Locatie AMC, University of Amsterdam, Amsterdam, The Netherlands",
        "Department of Molecular and Cellular Hemostasis, Sanquin Research, Amsterdam, The Netherlands"
      ],
      "name": "Karin Fijnvandraat"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Camila Caram-Deelder"
    },
    {
      "affiliations": [
        "Department of Neonatology, La Fe University Hospital, Valencia, Spain"
      ],
      "name": "Marta Aguar Carrascosa"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Centre Hospitalier Universitaire de Rennes, Rennes, France"
      ],
      "name": "Alain Beuchée"
    },
    {
      "affiliations": [
        "Women and Children’s Division, Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway"
      ],
      "name": "Kristin Brække"
    },
    {
      "affiliations": [
        "Division of Neonatology, Medical University of Vienna, Vienna, Austria"
      ],
      "name": "Francesco Stefano Cardona"
    },
    {
      "affiliations": [
        "Department of Neonatology, Universitair Ziekenhuis Leuven, Leuven, Belgium"
      ],
      "name": "Anne Debeer"
    },
    {
      "affiliations": [
        "Unidade Local de Saúde de Santo António, Centro Materno-Infantil do Norte, Porto, Portugal"
      ],
      "name": "Sara Domingues"
    },
    {
      "affiliations": [
        "Fondazione IRCCS Policlinico San Matteo, Pavia, Italy"
      ],
      "name": "Stefano Ghirardello"
    },
    {
      "affiliations": [
        "Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia"
      ],
      "name": "Ruža Grizelj"
    },
    {
      "affiliations": [
        "Paediatric Clinic, University Medical Center Sarajevo, Sarajevo, Bosnia and Herzegovina"
      ],
      "name": "Emina Hadžimuratović"
    },
    {
      "affiliations": [
        "Neonatal Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"
      ],
      "name": "Christian Heiring"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia",
        "Department of Neonatology, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia"
      ],
      "name": "Jana Lozar Krivec"
    },
    {
      "affiliations": [
        "Department of Pediatrics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic"
      ],
      "name": "Jan Maly"
    },
    {
      "affiliations": [
        "Jessenius Faculty of Medicine, Department of Neonatology, University Hospital Martin, Martin, Slovakia"
      ],
      "name": "Katarina Matasova"
    },
    {
      "affiliations": [
        "Department of Neonatology, University College Dublin, Dublin, Ireland",
        "Neonatology, National Maternity Hospital, Dublin, Ireland"
      ],
      "name": "Carmel Maria Moore"
    },
    {
      "affiliations": [
        "Department of Neonatology, University of Zurich, Zurich, Switzerland"
      ],
      "name": "Tobias Muehlbacher"
    },
    {
      "affiliations": [
        "Department of Neonatology, Semmelweis University, Budapest, Hungary"
      ],
      "name": "Miklos Szabo"
    },
    {
      "affiliations": [
        "II Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland"
      ],
      "name": "Tomasz Szczapa"
    },
    {
      "affiliations": [
        "Department of Neonatology, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania"
      ],
      "name": "Gabriela Zaharie"
    },
    {
      "affiliations": [
        "Division of Neonatology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Justine de Jager"
    },
    {
      "affiliations": [
        "Department of Neonatology, Charité–Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Nora Johanna Reibel-Georgi"
    },
    {
      "affiliations": [
        "NHS Blood and Transplant, London, UK"
      ],
      "name": "Helen V New"
    },
    {
      "affiliations": [
        "NHS Blood and Transplant, London, UK",
        "University of Oxford, Oxford, UK"
      ],
      "name": "Simon J Stanworth"
    },
    {
      "affiliations": [
        "Karolinska Institute, Stockholm, Sweden"
      ],
      "name": "Emöke Deschmann"
    },
    {
      "affiliations": [
        "National Perinatal Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK",
        "Faculty of Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Charles C Roehr"
    },
    {
      "affiliations": [
        "Department of Neonatology, Charité–Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Christof Dame"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Saskia le Cessie"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Johanna G van der Bom"
    },
    {
      "affiliations": [
        "Division of Neonatology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands"
      ],
      "name": "Enrico Lopriore"
    },
    {
      "affiliations": [],
      "name": "for the INSPIRE Study Group"
    }
  ],
  "title": "Plasma transfusions in neonatal intensive care units: a prospective observational study",
  "uid": "b099d2b2-ed38-5cdc-8e57-4b694993734b"
}