Utility Of Blood Components In Pediatric Patients – An Audit

Abstract

BACKGROUND The blood component implies separation of whole blood into various potential components like packed red cells, platelet rich plasma, fresh frozen plasma, cryoprecipitate and leucocytes. It is now a standard practice of all blood banks to manufacture different blood components from donated whole blood units and supply only components thereafter to patients. Hence, regular audit of blood and its component usage is essential to assess the blood utilization pattern and set ideal policies in all the blood using specialities. OBJECTIVE To analyze patterns and appropriateness of transfusion of blood and blood products using predetermined criteria in children of age group 1-18 years. MATERIALS AND METHODS A prospective study was carried out on patients fulfilling the inclusion and exclusion criteria requiring transfusion of blood and blood products in BLDEU Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapur. Study period: 1st December 2014 to 30th June 2016 All the patients between 1-18 years receiving blood and blood components were included in the study. A detailed history and examination of patients were recorded in a predesigned proforma. Reports of investigations like pretransfusion / postransfusion hematological parameters, coagulogram and peripheral smear were recorded. Each transfusion episode was assessed based on the predetermined criteria. RESULTS The present study recorded transfusion details of 149 pediatric patients receiving whole blood and blood components. Out of the total 214 episodes of transfusions of blood and blood components among 149 patients, 102 episodes (47.7%) were of whole blood transfusions, 67 episodes (31.3%) were of packed red cell transfusions, 26 episodes (12.1%) were of platelet transfusions, 19 episodes (8.9%) were of fresh frozen plasma transfusions. Out of the total 214 transfusion episodes, 126 (58.5%) were appropriate and 88 (41.5%) were inappropriate. Whole blood was most frequently inappropriately used, followed by platelets, fresh frozen plasma and packed red cells. The inappropriateness of whole blood was for achieving hemostasis in bleeding patients.CONCLUSION Educational programmes addressing appropriate use of blood products should be continued in order to decrease the risk of inappropriate transfusions. The requirements to meet established criteria is an effective mechanism to improve transfusion practices.