Assessment of Blood Products Transfusion in Tertiary Neonatal Intensive Care Units Ain Shams University

Abstract

Abstract Background Preterm Neonates, especially very low birth weight infants, remain a category of patients with high transfusion needs. Appropriate transfusion of neonates is vital when the potential clinical benefit outweighs the risk. However, the association between transfusion and adverse outcomes remains inconclusive. Aim Of The Work To evaluate transfusion practices in Tertiary Neonatal Intensive Care Units at Ain Shams University. Patients and Methods A cross sectional observational study was conducted on patients selected from Tertiary Neonatal Intensive Care Units at Ain Shams University- Children’s hospital. There were 703 neonates (29.64%) who received at least one type of blood products (packed red blood cells, platelets, fresh frozen plasma or cryoprecipitate) transfusion or underwent exchange transfusion during their hospital stay. All neonates receiving blood products transfusions were assessed for full history taking, clinical parameters i.e. gestational age, birth weight and general examination, indications for admission whether medical or surgical indications. Co-morbid illness such as bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, sepsis and patent ductus arteriosus were also noted. In addition, the indications for each of blood products transfusion i.e. anemia, exchange transfusion, thrombocytopenia, sepsis or other indications. Then, the requisition was assessed for pre- and post-transfusion laboratory parameters. Results Packed red blood cell was the most frequent blood component transfused (82.4%) and the main indication was anemia of prematurity (34.8%). There was a highly statistically significant increase in each of hemoglobin and hematocrit (HCT) post transfusion (with P value <0.0001) and a highly statistically decrease in the required median fraction of inspired oxygen (FiO2) (with P value <0.0001). 681 neonates (96.9%) presented with comorbidities; the most common comorbidity was neonatal sepsis in 81.2%. Packed red blood cells (PRBCs) transfusions were highly statistically significant related to comorbidity development. Conclusion Majority of blood transfusions occur during the first 2 weeks of life. Gestational age, birth weight, underlying disease of neonates, the need for oxygen support and blood collection within first two weeks of birth influence their transfusion needs. Sepsis remains the foremost etiological factor for blood component transfusion.