EBNEO Commentary: Red blood cell transfusion thresholds in extremely low birthweight infants

In this European multicentre randomised controlled trial, the Effects of Transfusion Thresholds on Neurocognitive Outcome of Extremely Low birth Weight Infants (ETTNO), 1013 preterm infants with a birthweight less than 1000 grams were included. The study was undertaken across 2011–2014 with longer term follow-up beyond this period. At 24 months’ corrected age, rates of the primary outcome of death or neurodevelopmental impairment were similar in the liberal and restrictive threshold groups (44.4% and 42.9%; odds ratio, 1.05). The rates of mortality, cognitive impairment and complications including bronchopulmonary dysplasia and necrotising enterocolitis were similar between groups.