Background: Blood transfusion is one of the lifesaving modalities in low birth weight babies. The very low birth weight  babies (VLBW) are the most common recipient of  multiple blood transfusion units due to their immaturity and illness and they are more vulnerable to adverse effects because of physiological immaturity of organ system. The doses generally used for PRBC is 20 ml/kg as a single aliquot which s well tolerated. The doses of 10 ml/kg in two different aliquots also practised and equally effective but tolerability varies. .

Objectives: To evaluate the safety and effectiveness of 20 mL/kg single aliquot vs 10 ml/kg of 2 aliquots of packed red cell transfusions in very low birth weight babies.

Study design: This will be a randomized double blind control trial and will be conducted in 20 bedded NICU in AVBRH hospital,Sawangi Meghe rural Hospital, Maharashtra. The total sample size is 104 and duration is 18 months. The inclusion and exclusion criteria’s has been defined and patients will be recruited as per the criteria.

Methodology and data analysis: Informed parental consent will be obtained for eligible patients and then each infant will be randomized, using a random number generator as decided by the computerised slip, to one of the two treatment sequences: one receiving 20 mL/kg transfusion and other 10 mL/kg , 2 aliquots , 24 hours apart. Vital signs will be monitored hourly during and up to 6 hours after transfusion. Haematocrit, haemoglobin, and red blood cell counts will also collected 1 hour before transfusion and for 3 hours after transfusion.The data’s will be entered in spread excel sheet. Mean and range of haemoglobin, haematocrit and other parameters will be calculated and compared between two methods. Mean in 2 groups will be calculated and compared using chi square test. P values will be calculated and P value >0.5 will be taken as significant.