Higher or lower haemoglobin transfusion thresholds for preterm infants?

Review of: Kirpalani H, Bell EF, Hintz SR, et al . Higher or lower hemoglobin transfusion thresholds for preterm infants. N Engl J Med 2020;383:2639–51. doi:10.1056/nejmoa2020248 Design: Open multicentre randomised clinical trial. Allocation: Central telephone randomisation, stratified according to trial centre and birth weight (<750 g or 750–1000 g). Infants were assigned in a 1:1 ratio. Blinding: Follow-up assessments were masked to the intervention. Study question: Does a higher haemoglobin threshold for red-cell transfusions reduce the risk of cognitive delay among extremely low-birth-weight infants with anaemia? Setting: 41 NICUs (19 centres) in a Neonatal Research Network in the USA. Patients: 1824 infants aged under 48 hours with a birth weight less than 1001 g and gestational age 22+0 to 28+6 weeks. Infants with cardiac conditions, family history of haemoglobinopathy, prior transfusions or significant …