Audit of transfusion practices in pediatrics in a tertiary care hospital

Authors

  • Vaishnavi Iyengar Department of Pediatrics, Shrimati Kashibai Navale Medical College and Hospital, Narhe, Pune, Maharashtra, India
  • Anjali Parekh Department of Pediatrics, Shrimati Kashibai Navale Medical College and Hospital, Narhe, Pune, Maharashtra, India
  • Sanjay Natu Department of Pediatrics, Shrimati Kashibai Navale Medical College and Hospital, Narhe, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20202159

Keywords:

Blood component therapy, Critically ill children, Fresh frozen plasma, Packed cell transfusion, Platelet transfusion

Abstract

Background: Audit of transfusion practices in pediatric patients was performed to study indications, clinical profile and whether transfusions were in accordance to guidelines.

Methods: Retrospective analysis of all episodes of transfusions from a tertiary care centre was done. The study period was from January 2018 to December 2018.Patients in the age group of 4 months to 12 years were enrolled in the study. The data was reviewed according to the British Committee for Standards in Haematology guidelines for transfusion.

Results: During the study period of 12 months,168 units of hemocomponents were transfused to children, 66.07% (111/168) of the total products transfused were packed red cell units, followed by 36 units (21.42%) of fresh frozen plasma and 21 units (12.5%) platelets. Overall usage of blood components was found to be appropriate in 58.33% (98/111). Red blood cells were the most appropriately transfused (64.86 %) (72 units out of 111) blood product as compared to 42.85% of platelets (9/21) and 47.22% of FFP (17/36).

Conclusions: Most frequently transfused blood components are red blood cells in pediatrics. Inappropriate transfusion of blood components is hinders the utility of this valuable resource, Thus it becomes necessary to conduct regular audit of blood component transfusion for optimum utilization.

References

Armano R, Gauvin F, Ducruet T, Lacroix J. Determinants of red blood cell transfusions in a pediatric critical care unit: a prospective, descriptive epidemiological study. Criti Care Medi. 2005 Nov 1;33(11):2637-44.

Morris KP, Naqvi N, Davies P, Smith M, Lee PW. A new formula for blood transfusion volume in the critically ill. Arch Disease Child. 2005 Jul 1;90(7):724-8.

Carson JL, Stanworth SJ, Roubinian N, Fergusson DA, Triulzi D, Doree C, et al. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochr Datab System Rev. 2016(10).

Hébert PC, Carson JL. Transfusion threshold of 7 g per decilitre-the new normal. N Engl J Med. 2014 Oct 9;371(15):1459-61.

Rohde JM, Dimcheff DE, Blumberg N, Saint S, Langa KM, Kuhn L, et al. Health care–associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA. 2014 Apr 2;311(13):1317-26.

Lacroix J, Hébert PC, Hutchison JS, Hume HA, Tucci M, Ducruet T, et al. TRIPICU investigators; Canadian critical care trials group; pediatric acute lung injury and sepsis investigators network. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 2007;356(16):1609-9.

Stanworth SJ, Brunskill SJ, Hyde CJ, McClelland DB, Murphy MF. Is fresh frozen plasma clinically effective? A systematic review of randomized controlled trials. Br J Haematol. 2004 Jul;126(1):139-52.

Yang L, Stanworth S, Hopewell S, Doree C, Murphy M. Is fresh‐frozen plasma clinically effective? An update of a systematic review of randomized controlled trials (CME). Transfusion. 2012 Aug;52(8):1673-86.

Stanworth SJ, Grant‐Casey J, Lowe D, Laffan M, New H, Murphy MF, et al. The use of fresh‐frozen plasma in England: high levels of inappropriate use in adults and children. Transfusion. 2011 Jan;51(1):62-70.

Gibson BE, Todd A, Roberts I, Pamphilon D, Rodeck C, Bolton-Maggs P, et al. Transfusion guidelines for neonates and older children. Br J Haematol. 2004 Feb;124(4):433-53.

Slonim AD, Joseph JG, Turenne WM, Sharangpani A, Luban NL. Blood transfusions in children: a multi‐institutional analysis of practices and complications. Transfusion. 2008 Jan;48(1):73-80.

Bahadur S, Sethi N, Pahuja S, Pathak C, Jain M. Audit of pediatric transfusion practices in a tertiary care hospital. Ind J Pediatr. 2015 Apr 1;82(4):333-9.

Ahmed M, Sushma US. Blood component therapy in paediatric Intensive Care Unit in tertiary care centre: An audit. Int J Contemp Med Res. 2016;3:1506-10.

Chalabi Hamoudi A, Cecalupo AJ, Wolf ML, Coe SA, Menke JA. The use of LIS for blood usage review: Experience in a children's hospital. Am J Clini Pathol. 1991 Mar 1;95(3):389-92.

Hume HA, Ali AM, Decary F, Blajchman MA. Evaluation of pediatric transfusion practice using criteria maps. Transfusion. 1991 Jan;31(1):52-8.

Wade M, Sharma R, Manglani M. Rational use of blood components-an audit. Ind J Hematol Blood Transfus. 2009 Jun 1;25(2):66-9.

Martí-Carvajal AJ, Muñoz-Navarro SR, Martí-Peña AJ, del Carmen Matheus-Fernández E, Medina-Laurentín MC. Appropriate Use of Blood Products in Pediatric Patients in a Venezuelan General University Hospital: cross-sectional study. Salus. 2005;9(1):20-30.

Uppal P, Lodha R, Kabra SK. Transfusion of blood and components in critically ill children. Ind J Pediatr. 2010 Dec 1;77(12):1424-8.

Strauss RG. Transfusion therapy in neonates. Am J Dis Child. 1991 Aug 1;145(8):904-11.

Haslindawani WW, Zaidah AW. Coagulation parameters as a guide for fresh frozen plasma transfusion practice: A tertiary hospital experience. Asian J Transfus Scie. 2010 Jan;4(1):25.

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Published

2020-05-22

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Original Research Articles