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- W4251949745 abstract "We agree that recent studies have questioned the reliability and usefulness of routine coagulation profile and C-reactive protein measurements in the early postnatal period.1Perrone S. Lotti F. Longini M. Rossetti A. Bindi I. Bazzini F. et al.C reactive protein in healthy term newborns during the first 48 hours of life.Arch Dis Child Fetal Neonat Ed. 2018; 103: F163-F166Google Scholar, 2Macallister K. Smith-Collins A. Gillet H. Hamilton L. Davis J. Serial C-reactive protein measurements in newborn infants without evidence of early-onset infection.Neonatology. 2019; 116: 85-91Crossref PubMed Scopus (12) Google Scholar, 3Pal S. Curley A. Stanworth S.J. Interpretation of clotting tests in the neonate.Arch Dis Child Fetal Neonat Ed. 2015; 100: F270-F274Crossref PubMed Scopus (35) Google Scholar However, these studies predominantly evaluated healthy term and late preterm infants. In sick, extremely premature neonates, clinicians may have a greater inclination to obtain these measurements. Therefore, a substantial proportion of extremely preterm populations may undergo these tests even if not part of routine screening. We wholeheartedly agree that our study not only demonstrates the benefits of cord blood sampling, but also highlights an important corollary: the potential impact of minimizing blood losses in high-risk neonates. We focused on admission blood sampling because it could account for up to 30% of sampling losses occurring in the first month of age.4Carroll P.D. Widness J.A. Nonpharmacological, blood conservation techniques for preventing neonatal anemia–effective and promising strategies for reducing transfusion.Semin Perinatol. 2012; 36: 232-243Crossref PubMed Scopus (54) Google Scholar The findings from our study lead to another important scientific question: the impact of limiting phlebotomy losses in the first postnatal month on transfusion needs in extremely premature neonates. Mathematical studies have modelled the extent to which laboratory blood loss could contribute to neonatal anemia,5Rosebraugh M.R. Widness J.A. Nalbant D. Veng-Pedersen P. A mathematical modeling approach to quantify the role of phlebotomy losses and need for transfusions in neonatal anemia.Transfusion. 2013; 53: 1353-1360Crossref PubMed Scopus (32) Google Scholar but the effect of limiting phlebotomy losses in extremely premature neonates remains to be studied. We agree that investigating a “limited phlebotomy approach” and validating point of care analyzers in extremely premature infants are the first logical steps in that direction. But until such approaches are widely adopted, and point-of-care analyzers widely available with quality control, cord blood sampling provides an immediate solution to minimize anemia in extremely premature infants in a variety of neonatal intensive care settings. Cord blood sampling in preventing anemia in extremely preterm infantsThe Journal of PediatricsVol. 214PreviewTo the Editor: Full-Text PDF" @default.
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- W4251949745 date "2019-11-01" @default.
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- W4251949745 doi "https://doi.org/10.1016/j.jpeds.2019.07.007" @default.
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