Evaluation of blood component transfusion in sick neonates- a retrospective study in a rural tertiary new-born care unit of Eastern India

Authors

  • Bidyut Kumar Khuntdar Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India
  • Surjit Naik Associate Professor, Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India
  • Kajal Kumar Patra Department of Gynae and Obstetrics, Gouri Devi Institute of Medical Science, Durgapur, West Bengal, India
  • Manabendra Sau Department of Community Medicine, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India
  • Kishore P. Madhwani Occupational Health and Wellness Consultant, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20222769

Keywords:

Blood component, Complication, Indication, Neonates

Abstract

Background:  In recent past, blood transfusion in neonates has developed a lot improving the outcome particularly in premature and low birth weight babies. However, there are no globally followed standardised guidelines for neonatal blood transfusion. The present study conducted with the objective to evaluate the frequency, indications, complications and appropriateness of various blood components transfusion in sick newborn care unit (SNCU) of a resource poor setting.

Methods: This retrospective, hospital based, single centre observational study is done in a tertiary care SNCU of a teaching hospital of eastern India. All SNCU admitted neonates who received blood/ blood component transfusion from October 2018 to September 2019 were evaluated for blood component usage and their indications and followed up throughout hospital stay. The data were statistically analysed using Microsoft Excel™ software.

Results: In this study 219 neonates received a total of 359 bags of blood component transfusion. Out of these packed red blood cell (PRBC), fresh frozen plasma (FFP), random donor platelet and whole blood were 233 (64.90%), 97 (27.01%), 10 (2.78%) and 19 (5.29%) respectively. The major indications for transfusion were anaemia of prematurity (35.37%), sepsis (26.18%) and bleeding disorder (16.71%). The common transfusion-related complications observed in our study were cardiac abnormality (22.35%), electrolyte disturbance (6.40%) and hypoglycaemia (19.17%).

Conclusions: Anaemia of prematurity was the foremost indication of transfusion. Multiple transfusions were associated with prematurity and low birth weight.

Author Biographies

Bidyut Kumar Khuntdar, Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India

Associate Professor,

Dept of Community Medicine,

R.G. Kar Medical College and Hospital,

1, Khudiram Bose Sarani, Bidhan Sarani,

Kolkata - 700004, West Bengal, India  

Surjit Naik, Associate Professor, Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India

Associate Professor, Department of Pediatrics, Midnapore Medical College, Midnapore, West Bengal, India

Kajal Kumar Patra, Department of Gynae and Obstetrics, Gouri Devi Institute of Medical Science, Durgapur, West Bengal, India

Assistant Professor, Department of Pediatrics, Bhima Bhoi Medical College and Hospital, Balangir, Odisha, India

Manabendra Sau, Department of Community Medicine, R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India

Professor and Head, Dept of Gynae and Obstetrics, Gouri Devi Institute of Medical Science, Durgapur, West Bengal, India

Kishore P. Madhwani, Occupational Health and Wellness Consultant, Mumbai, Maharashtra, India

Occupational Health & Wellness Consultant, Mumbai, Maharashtra, India

References

Dogra K, Kaur G, Basu S, Chawla D. Red cell transfusion practices in neonatal intensive care unit: an experience from tertiary care centre. Indian J Hematol Blood Transfus. 2018;34:671-6.

Jain R, Jose B, Coshic P, Agarwal R, Deorari AK. Blood and blood component therapy in neonates. Indian J Pediatr. 2008;75(5):489-95.

Agarwal R, Deorari A, Paul VK. In: AIIMS Protocols in Neonatology 1st ed. New Delhi: CBS Publishers and Distributors. 2015.

Bishara N, Ohls RK. Current controversies in the management of the anemia of prematurity. Semin Perinatol. 2009;33(1):29-34.

Murray NA, Roberts IAG. Neonatal transfusion practice. Arch Dis Child FN. 2004;89:101-7.

Jain R, Jose B, Coshic P. Blood and blood component therapy in neonates. Indian J Pediatr. 2008;75:489-95.

Bhattacharya P, Marwaha N, Dhawan HK, Roy P, Sharma RR. Transfusion-related adverse events at the tertiary care center in North India: an institutional hemovigilance effort. Asian J Transfus Sci. 2011;5:164-70.

Wade M, Sharma R, Manglani M. Rational use of blood components-an audit. Indian J Hematol Blood Transfus. 2009;25:66-9.

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

Outcomes after implementing restrictive blood transfusion criteria in extremely premature infants. Knee D, Knoop S, Davis AT, Rawson B, DiCarlo A, Olivero R. J Perinatol. 2019;39:1089-97.

Galel SA, Fontaine MJ, Viele MK, Gonzalez L, Goodnough LT. Wintrobe's Clinical Hematology: Thirteenth Edition. The Netherlands: Wolters Kluwer Health Adis (ESP). Transfusion Med. 2013;547-86.

Sola-Visner M. Platelets in the neonatal period: developmental differences in platelet production, function, and hemostasis and the potential impact of therapies. Hematology Am Soc Hematol Educ Program. 2012;2012:506-11.

Curley A, Venkatesh V, Stanworth S. Platelets for neonatal transfusion-study 2: a randomised controlled trial to compare two different platelet count thresholds for prophylactic platelet transfusion to preterm neonates. Neonatology. 2014;106:102-6.

Keir AK, Stanworth SJ. Neonatal plasma transfusion: an evidence-based review. Transfus Med Rev. 2016;30:174-82.

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Published

2022-10-27

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Original Research Articles