Blood Component Transfusion in Tertiary Care Neonatal Intensive Care Unit and Neonatal Intermediate Care Unit: An...

Area of Science:

• Neonatal Medicine
• Pediatric Hematology
• Transfusion Medicine

Background:

• Neonates in tertiary neonatal intensive care units (NICUs) often require multiple blood transfusions due to prolonged stays and frequent sampling.
• Immature organ systems and limited blood volume in neonates necessitate regular audits of transfusion practices.
• Sharing component usage data with blood banks can optimize inventory, reduce waste, and prepare for demand fluctuations.

Purpose of the Study:

• To audit the indications for blood transfusions in neonates admitted to NICU and Neonatal Intermediate Care Unit (NIMC).
• To identify the most commonly used blood component in neonatal transfusions.
• To evaluate the necessity of whole blood transfusions in neonates.

Main Methods:

• Retrospective cohort study analyzing medical records of neonates receiving transfusions (fresh frozen plasma, red cell concentrate, platelets, exchange transfusion) between February 2017 and December 2018.
• Data collected from 2011 to 2016 for NICU and NIMC patients.
• Descriptive statistical analysis and Chi-square test applied; patients categorized using ICD-11 classification.

Main Results:

• Out of 340 neonates, 73.2% were low birth weight, 40.9% were small for gestational age (SGA), and 81.5% required transfusion within the first week of life.
• Fresh frozen plasma (FFP) was the most frequently transfused component (37.82%), followed by red cell concentrate (RCC) (31.34%) and platelet concentrate (28.14%).
• Neonatal sepsis, Disseminated intravascular coagulopathy (DIC), low birth weight, respiratory distress syndrome, and unconjugated hyperbilirubinemia were primary indications for transfusion.

Conclusions:

• Fresh frozen plasma (FFP) is the most commonly transfused component, primarily indicated for neonatal sepsis in preterm infants.
• Whole blood transfusions are still utilized but are deemed unnecessary and should be discontinued.
• Auditing transfusion practices is crucial for optimizing neonatal care and blood bank resource management.