Analyzing blood transfusion practices for pediatric and neonatal patients: A tertiary center experience from Central India

Blood transfusion is essential in managing pediatric patients with various medical and surgical conditions. Despite the high demand for pediatric transfusions, comprehensive national data on transfusion practices in India are lacking. This study aims to identify the proportion of blood utilized for pediatric patients, determine the most common medical and surgical transfusion indications, and evaluate differences in indications based on age groups.

A retrospective cross-sectional study was conducted over 1 year and analyzed transfusion requisitions for patients aged ≤18 years. The study included neonatal (≤1 month) and pediatric (>1 month to ≤18 years) patients. All blood requisition forms were screened for laboratory parameters and indications and divided into appropriate and inappropriate episodes according to the British Committee for Standards in Haematology (BCSH) guidelines for transfusion in fetuses, neonates, and older children.

Out of 15,949 blood requisitions, 3207 (20.10%) were for neonatal and pediatric patients. Medical reasons (71.4%) were the primary cause for transfusions, with anemia (43.01%), thrombocytopenia (24.89%), and coagulopathy (19.69%) being the most common. Surgical indications accounted for 27.93% of transfusions, with gastrointestinal surgery (13.5%) and orthopedics (9.26%) being frequent reasons. Packed red blood cells were the most requested component (61.89%), followed by platelets (21.85%) and fresh frozen plasma (FFP, 11.16%). In total component requisitions (3207), 64.1% were appropriate, and 35.9% requisitions were inappropriate according to the BCSH guidelines. Most of the inappropriate requisitions were received for FFP components.

The study highlights the significant demand for pediatric transfusions, predominantly for medical indications. The findings are consistent with global patterns, underscoring the importance of tailored transfusion protocols and comprehensive management strategies for pediatric patients. This study provides crucial insights into pediatric transfusion practices in Central India, emphasizing the need for region-specific guidelines and improved clinical practices to enhance patient outcomes.