Fresh blood for ill babies not necessarily better, says study

Acutely ill premature babies who received fresher blood do not fare better than other similarly ill babies receiving the current standard of care, according to new research.

There was no difference between the two approaches regarding mortality, infection and injury to major organs, said a clinical trial published today (October 8th) by the journal of the American Medical association.

Prior to this study, the majority of literature on the issue implied that fresh red blood cells are superior, explained lead author Dr Dean Fergusson, head of the Clinical Epidemiology Program at the Ottawa Hospital Research Institute and associate professor at the University of Ottawa.

The results of fresher blood on clinical outcomes using a randomised clinical trial in human patients have never been examined previous to this, and this process is thought of as the "gold standard" in medical science, said the doctor.

It has now been tested and the standards presently in place have the same effect on extremely vulnerable pre-term infants as a policy and system that uses fresh blood.

The Age of Red Blood Cells in Premature Infants (ARIPI) Randomised Trial involved 377 babies weighing less than 1,250 grams and needing red blood cell transfusions.

They either received "fresh" blood that had been stored a week or less, or received the existing standard of practice utilised by blood banks.

Results showed that there was no difference between the two groups.

Hundreds of parents gave permission for their children to take part in the study, which occurred from May 2006 to June 2011.

"For the families, it's a difficult decision at a difficult time to allow their tiny and fragile child to be a part of a clinical trial. On behalf of the entire team, I salute and thank them," said Dr Nicole Rouvinez-Bouali, academic neonatologist at the Children's Hospital of Eastern Ontario.

The ARIPI trial included six Canadian hospitals: The Ottawa Hospital, Children's Hospital of Eastern Ontario (Ottawa), Jewish General Hospital (Montreal), Royal University Hospital (Saskatoon), Children's and Women's Health Centre of British Columbia (Vancouver), and CHU Sainte-Justine (Montreal).

Posted by Fiona Griffiths