A Clinical Audit of blood component transfusion practices in Paediatric intensive care unit of a Tertiary Care Hospital, Rawalpindi
Background: To audit the practices involved in blood component transfusion in the management of patients in paediatric intensive care unit of our hospital and to determine the appropriateness of transfusion after comparing them with clinical practice guidelines recommended by Royal Children Hospital (RCH).
Methods: All patients admitted in pediatric intensive care which were managed with blood component transfusions were retrospectively audited for 8 weeks. Management details including indications of transfusion and its appropriateness were recorded. Clinical practice guidelines recommended by Royal Children Hospital (RCH) were used as standards.
Results: One hundred and ninety-two transfusions were done during the study period out of which 58 percent were done to males and 41 percent to females. Majority of transfusions were done in infants (44%) and O Positive blood group was found rampant among blood groups of all recipients (33.3%). Red cell concentrates were predominantly (55.7%) and appropriately (72%) transfusion among all blood components. Platelet concentrates were most inappropriately transfused (57%) followed by fresh frozen plasma (54%) and red cell concentrates (27%). There was significant percentage of inappropriate transfusion of all blood components (p=0.00).
Conclusion: All blood components were significantly found inappropriately transfused, commonest component being platelet concentrates.
2. Hanson SJ, Owen EB, McDonald MJ, Woods KJ, Montgomery VL. Standardized Implementation of Evidence-based Guidelines to Decrease Blood Transfusions in Pediatric Intensive Care Units. Pediatr Qual Saf. 2019;4(3):e165-e165. doi:10.1097/pq9.0000000000000165
3. Valentine SL, Bembea MM, Muszynski JA, et al. Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr Crit Care Med. 2018;19(9):884-898. doi:10.1097/PCC.0000000000001613
4. Ali N. Red blood cell transfusion in infants and children – Current perspectives. Pediatr Neonatol. 2018;59(3):227-230. doi:https://doi.org/10.1016/j.pedneo.2017.10.002
5. Muszynski JA, Guzzetta NA, Hall MW, et al. Recommendations on RBC Transfusions for Critically Ill Children With Nonhemorrhagic Shock From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatr Crit Care Med. 2018;19(9S Suppl 1):S121-S126. doi:10.1097/PCC.0000000000001620
6. Aslam HM, Saleem S, Afzal R, et al. “Risk factors of birth asphyxia.” Ital J Pediatr. 2014;40:94. doi:10.1186/s13052-014-0094-2
7. 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(4):333-339. doi:10.1007/s12098-014-1370-2
8. Alsheikh B, Chegondi M, Totapally B. Platelet Transfusion Thresholds Among Children Admitted to a Pediatric Intensive Care Unit. Cureus. 2017;9(10):e1797-e1797. doi:10.7759/cureus.1797
9. Sharma A, Parveen H, Ranga S, Arora R. Assessment of Appropriate Use of Blood Products in a Tertiary Care Center in India- An Audit Study. J Evid Based Med Healthc. 2020;7:1239-1244. doi:10.18410/jebmh/2020/264
10. Sharif M, Saxena A, Singh S, Manchala S, Jafri N. Blood Component Transfusion in a Tertiary Care Hospital. Indian J Pediatr. 2020;87(5):339-344. doi:10.1007/s12098-020-03186-2
11. Kapse DV. An Audit of Pattern of Transfusion in Tertiary Care Hospital. J Med Sci Clin Res. 2018;6(7):413-417. doi:10.18535/jmscr/v6i7.70
12. Faria JCP, Victorino CA, De Souza FIS, Do Sarni ROS. Assessment of the prescription of red blood cell concentrates in the pediatric age group. Rev Assoc Med Bras. 2018;64(2):181-186. doi:10.1590/1806-9282.64.02.181
13. Okoroiwu HU, Okafor IM. Demographic characteristics of blood and blood components transfusion recipients and pattern of blood utilization in a tertiary health institution in southern Nigeria. BMC Hematol. 2018;18:16. doi:10.1186/s12878-018-0112-5
14. Iyengar V, Parekh A, Natu S. Audit of transfusion practices in pediatrics in a tertiary care hospital. Int J Contemp Pediatr Vol 7, No 6 June 2020 DOI - 1018203/2349-3291.ijcp20202159. Published online May 22, 2020. https://www.ijpediatrics.com/index.php/ijcp/article/view/3417
15. Wade M, Sharma R, Manglani M. Rational use of blood components - an audit. Indian J Hematol Blood Transfus. 2009;25(2):66-69. doi:10.1007/s12288-009-0016-4
16. Hill-Strathy M, Pinkerton PH, Thompson TA, et al. Evaluating the appropriateness of platelet transfusions compared with evidence-based platelet guidelines: An audit of platelet transfusions at 57 hospitals. Transfusion. 2021;61(1):57-71. doi:10.1111/trf.16134
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