Minimizing donor blood exposure in the neonatal intensive care unit. Current trends and future prospects.

Limitations in the knowledge of the pathophysiology of anemia contribute to unfounded and liberal transfusion practices in the preterm infant and to uncertain risk-benefit ratios. Researchers have explored an array of strategies to minimize transfusions. Such strategies include collection and banking of autologous placental blood, administration of recombinant erythropoietin, innovations in blood banking practices, and improved definitions of the markers of anemia with more rigorous transfusion guidelines. This article presents an overview of these and other strategies that can be applied as part of an overall approach to limit effectively the number of transfusions in the newborn.