An evaluation of the safety of blood product transfusion in children under 18: systematic review

Background: Every year, blood transfusions save countless lives, extend life expectancy, enhance the condition of life of individuals with life-threatening illnesses. The rate of blood transfusion reactions in children is higher than in the general population of adults. As children grow and develop, they are very different from adults regarding how they need to be diagnosed and treated. Objective: The systematic review aimed to evaluate potential adverse consequences and correlations associated with blood transfusions in children. Methods: A literature search was carried out using PubMed, Scopus, Embase, MEDLINE, CINAHL, Web of Science, and Cochrane. A manual search was also undertaken using reference harvesting in ARU. The literature search was done to cover the duration between 2011 to 2021 using Boolean logic with the following terms: Blood transfusion, Transfusion Safety, Adverse effects/Transfusion, Transfusion reaction, and Children. Results: The majority of the studies discussed RBC transfusion among critically ill children. They all reach an almost similar opinion that there are adverse effects associated with blood transfusion, especially in immunocompromised children or neonates. Discussions about plasma transfusions also showed the same results. The significant outcomes of the blood transfusion are nosocomial infections, prolonged hospital stay, early mortality, and transfusion-related hyperkalaemia. Although transfusion is a valuable therapy, there is always the possibility of side effects, with a greater occurrence rate in children under the age of 18, thus the healthcare team must respond quickly to minimise problems and control those that do occur. Conclusions: Acute and chronic diseases usually necessitate blood transfusions. This systematic study emphasises paediatric transfusion responses and shows that the incidence of transfusion reactions among the paediatric population is on the rise. More research is necessary to explain suitable indications and the introduction of standardised protocols for the blood transfusion process and subsequent reactions in children.