LOW DEGREE OF REGIONALIZATION AND HIGH TRANSFUSION RATES IN VERY-LOW-BIRTH-WEIGHT INFANTS - A SURVEY IN GERMANY

Although anemia is common in very low birthweight (VLBW) infants, wide ly accepted guidelines for red blood cell transfusions are lacking. Qu estionnaires regarding transfusion policy in VLBW infants in 1994 were sent to 391 German pediatric departments. 208 questionnaires were ret urned. 51 departments reported not to admit VLBW infants. Thus, result s are based on 157 completed questionnaires. 54 % of the respondents a dmitted less than 30 VLBW infants per year and 52 % of the VLBW infant s were admitted to departments with less than 50 VLBW infants per year . Overall transfusion rate ranged from 0 to 100 % (median 65 %). This range narrowed with the departments' size indicating stricter guidelin es with less variation. Indication for transfusion varied considerably depending on the infants' postnatal age and need for ventilatory supp ort. 34 % of the respondents applied directed transfusions. most frequ ently from the infant's father. 70 % used satellite packs. 51 % stored the packs up to 7 days, 10 % longer than 14 days. Red cells were irra diated in 35 %,and washed in 23 % of the departments. Median single tr ansfusion volume was 12 ml/kg. We conclude that regionalization of VLB W infants in Germany is far from completeness and that hospital polici es for transfusion show large variety especially in small departments.