INSPIRE-study – International Neonatal tranSfusion PoInt pREvalence

The INSPIRE-study is an international research initiative that examines current neonatal blood transfusion practices across Europe to improve care for preterm infants and support the development of evidence-based guidelines.

It includes preterm infants born before 32 weeks of gestation who are admitted to a tertiary-level NICU. More than 60 NICUs across 19 European countries are participating in the study.

Over a one-year period, each NICU collects clinical data for six selected weeks, allowing for a comprehensive snapshot of neonatal transfusion practices in different regions.

The expected outcomes of the INSPIRE-study include:

A detailed overview of current transfusion practices across Europe
Evidence to support the development of future clinical studies
Insights to inform the creation of evidence-based transfusion guidelines
Increased awareness that may help to reduce unnecessary transfusions in this vulnerable population

Background

Most preterm infants admitted to a Neonatal Intensive Care Unit (NICU) receive blood transfusions. However, some newborns receive transfusions unnecessarily, which can lead to side effects or even harm. Currently, there are no unified international guidelines that have been adopted across Europe, resulting in significant variation in transfusion practices between countries. Moreover, high-quality data on neonatal transfusion practices across Europe is limited.

The International Neonatal tranSfusion PoInt pREvalence (INSPIRE) study aims to address these gaps by:

Describing the current state of blood transfusions in preterm infants across Europe
Identifying the indications for transfusion
Highlighting the use and variation of existing guidelines among different countries

The Neonatal Transfusion Network (NTN)

The INSPIRE-study is conducted by the Neonatal Transfusion Network (NTN), an international, interdisciplinary collaboration of researchers focused on neonatal transfusion medicine.

NTN’s mission is to:

Improve current transfusion practices
Generate robust clinical evidence to guide safe and effective neonatal care

GFCNI's Role in the INSPIRE-study

In collaboration with the Neonatal Transfusion Network (NTN), GFCNI coordinated an international Parent Advisory Board (PAB). This board provided valuable input and feedback on project materials, including the study protocol. GFCNI chaired the PAB, which met regularly throughout the duration of the INSPIRE-study.

In addition to coordinating the PAB, GFCNI also:

Advised on ethical considerations
Contributed to the development of patient information materials
Ensured that the parental perspective was integrated throughout the project

Expert Collaboration and Clinical Recommendations

In 2023, international experts from the Neonatal Transfusion Network and the United States met virtually to discuss current transfusion practices and review evidence from clinical trials on neonatal red blood cell transfusions.

As part of this initiative, the NTN established a Steering Committee to develop clinical practice recommendations for neonatal transfusions.

GFCNI, along with two parent representatives, actively participated in the meeting to share feedback and insights from a patient and family-centered perspective.

Parent Advisory Board (PAB) Meetings

In 2022 and 2023, three Parent Advisory Board meetings were held for the INSPIRE study. These meetings brought together parent representatives and members of the Neonatal Transfusion Network to discuss and share experiences related to neonatal blood transfusions in Europe.

Key outcomes of the meetings included:

Contributions to the study design and materials
Inclusion of parental input in the manuscript development
Strengthened collaboration between families and researchers

We extend our sincere thanks to all participating parents for their invaluable contributions to this important project.

For more information about the INSPIRE study, visit the Neonatal Transfusion Network website.

Transparency

The INSPIRE study is funded by the Sanquin Blood Supply Foundation (Dutch Blood Bank), the European Society for Pediatric Research (ESPR), and the European Blood Alliance (EBA).

GFCNI was actively involved in the project from September 2021 to September 2023.