Case Comparison of Preterm Infant Stability During Packed Red Blood Cell Transfusions

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Abstract
Background: Very preterm infants (less than 32 weeks gestational age) experience acute morbidity during their stay in a neonatal intensive care unit. Because of their prematurity and frequent laboratory testing, they experience anemia, requiring correction with packed red blood cell (PRBC) transfusion(s). PRBC transfusions have been linked to neonatal morbidity, such as necrotizing enterocolitis, but never signs and symptoms of physiological stability. Objective: The secondary data analysis aimed to examine very preterm infants’ physiological stability before, during, and after PRBC transfusions. Methods: A within-case, mixed-methods design was used in a secondary data analysis for 16 transfusion cases from 13 very preterm infants. Results: The findings showed very preterm infants with physiological variables falling within defined limits based on gestational age during the transfusion. Two contrasting case exemplars will be presented. Discussion: PRBC transfusions are necessary and prevent morbidity in very preterm infants. Observing instability during transfusions and prospectively studying hypothermia, cardiac instability, and thermal gradients is essential to design interventions to decrease morbidity associated with PRBC transfusions.

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