A new paper published in Transfusion urges a paradigm shift in how blood products are used in newborn care, a change that could have important implications for babies with conditions like fetal and neonatal alloimmune thrombocytopenia (FNAIT).
Traditionally, studies on neonatal transfusions have focused on one blood product at a time, such as red blood cells, platelets or plasma. But as the study authors point out, most preterm or critically ill newborns, including those affected by FNAIT, receive multiple transfusions during their hospital stay. Looking at each product in isolation may miss the combined effects of different blood components given close together or repeatedly over time.
For infants with FNAIT, platelet transfusions are often essential, sometimes alongside red cell or plasma transfusions. Understanding how these products interact, as well as how repeated or overlapping transfusions might affect outcomes, could help clinicians make better, more individualized treatment decisions.
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The authors propose a new research framework that considers the “whole system” of transfusion exposure: not just which products are used, but when, how often and in what sequence. This approach could reveal hidden relationships between transfusions and outcomes such as bleeding risk, immune response or organ function
“By looking at the whole instead of its parts, we can gain a more comprehensive understanding of the impact of transfusion exposure, potential associated adverse effects, and their implications for neonatal care,” they wrote.
While such a model would make research more complex, it could also lead to safer, more precise care, the researchers argue. As neonatal care continues to progress, this call to rethink how we study transfusions may help close gaps in research and ultimately guide more refined, individualized transfusion practices for babies with conditions like FNAIT.
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