Electronic health data exploring cardiorespiratory responses of transfusions in preterm infants: An international multicenter cohort study
- 1Department of Neonatology, Pediatric Pneumology and Neuropediatrics, Universitatsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
Abstract
Background and ObjectivesPreterm infants are commonly transfused, yet direct cardiorespiratory effects of red blood cell (RBC) transfusions remain poorly understood. We explored the feasibility of using multicentre electronic health data (EHD) to study such cardiorespiratory responses.
MethodsHighly granular routine EHD were collected from preterm infants born <32 weeks gestational age at three European centres. Heart rate, oxygen saturation, and respiratory rate were evaluated 12 hours before and after the RBC transfusion.
ResultsA total of 321 transfusions in 164 infants were analysed. Overall, there was no significant change in the rate of bradycardia and apnoea following transfusion. Cardiorespiratory parameters varied substantially between infants; e.g. 20% of transfusions were associated with an unexpected, significant increase in heart rate. Respiratory rate and oxygen saturation exhibited similarly heterogenous patterns following transfusion. In sub-group analysis, the proportion of transfusions with increased heart rate was significantly higher within the first two weeks than later (32% vs 13%, p=0.0019).
ConclusionsMulticentre EHD extraction allows to identify otherwise masked short-term effects of RBC transfusions on cardiorespiratory parameters, possibly indicating cardiac or pulmonary overload. Such effects may vary with adaptation to anaemia. Analysing EHD may ultimately enable personalized transfusion practice.
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BibTeX
@misc{honore2026electronic,
title = {{Electronic health data exploring cardiorespiratory responses of transfusions in preterm infants: An international multicenter cohort study}},
author = {A. Honore and T. Rech and A. Scrivens and I. Binotto and C. S. Zandvoort and H. van der Staaij and M. Peck and S. Zivanovic and S. J. Stanworth and C. Hartley and C. Dame and E. Deschmann and the Neonatal Transfusion Network},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.01.26361418},
url = {https://www.medrxiv.org/content/10.64898/2026.09.01.26361418v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Electronic health data exploring cardiorespiratory responses of transfusions in preterm infants: An international multicenter cohort study
AU - A. Honore
AU - T. Rech
AU - A. Scrivens
AU - I. Binotto
AU - C. S. Zandvoort
AU - H. van der Staaij
AU - M. Peck
AU - S. Zivanovic
AU - S. J. Stanworth
AU - C. Hartley
AU - C. Dame
AU - E. Deschmann
AU - the Neonatal Transfusion Network
PY - 2026
DA - 2026/09/01
PB - medRxiv
DO - 10.64898/2026.09.01.26361418
UR - https://www.medrxiv.org/content/10.64898/2026.09.01.26361418v1
AB - Background and ObjectivesPreterm infants are commonly transfused, yet direct cardiorespiratory effects of red blood cell (RBC) transfusions remain poorly understood. We explored the feasibility of using multicentre electronic health data (EHD) to study such cardiorespiratory responses. MethodsHighly granular routine EHD were collected from preterm infants born <32 weeks gestational age at three European centres. Heart rate, oxygen saturation, and respiratory rate were evaluated 12 hours before and after the RBC transfusion. ResultsA total of 321 transfusions in 164 infants were analysed. Overall, there was no significant change in the rate of bradycardia and apnoea following transfusion. Cardiorespiratory parameters varied substantially between infants; e.g. 20% of transfusions were associated with an unexpected, significant increase in heart rate. Respiratory rate and oxygen saturation exhibited similarly heterogenous patterns following transfusion. In sub-group analysis, the proportion of transfusions with increased heart rate was significantly higher within the first two weeks than later (32% vs 13%, p=0.0019). ConclusionsMulticentre EHD extraction allows to identify otherwise masked short-term effects of RBC transfusions on cardiorespiratory parameters, possibly indicating cardiac or pulmonary overload. Such effects may vary with adaptation to anaemia. Analysing EHD may ultimately enable personalized transfusion practice.
ER -