Analysis of Transfusion of Packed Red Blood Cells in Neonates in Neonatal Intensive Care Unit

Background: The small blood volume and immature organ systems in the neonate necessitate special approaches in neonatal transfusion practice. Blood components in the form of packed red cells are mainstay of treatment in neonatal intensive care units. Due to increasing demand of transfusion therapy in neonatal age group, it is of prime importance to ensure the quality, accurate dose and well-defined indication of the component transfused. Aim: To analyze the transfusion practices of neonates in neonatal intensive care unit. Materials and methods: The study was conducted in the department of IHBT, GMC Jammu done over a period of 1 year. This is prospective observational study comprising of 76 neonates who were admitted in neonatal intensive care unit and received transfusion therapy in the form of packed cells. Results: Out of 76 neonates, 45 (59.21%) neonates were females and 31 (40.79%) neonates were males. 62 (81.58%) were preterm and 14 (18.42%) were term neonates. 5 neonates (6.58%) were extremely low birth weight, 11 (14.47%) were Very low birth weight, 46 (60.53%) were low birth weight and 14 (18.42%) were normal birth weight. Small volume transfusions were given mainly comprising of 18 (25.71%) who received volume less than 15 ml, 40 (57.14%) received 16-25 ml and 12 (17.14%) were transfused with volume more than 25 ml of PRBC. Shock was found to be the major indication for transfusion in 30 neonates (39.47%) followed by anemia (25%), bleeding (18.42%), sepsis (11.84%) and hypoxic ischemic encephalopathy (1.32%). 31 neonates (41.33%) received single transfusion and 44 neonates (58.67%) received multiple transfusion. Donor exposure is calculated based on the feasibility of multiple aliquots from single donor unit of PRBC. 72.6% neonates were exposed to 1 donor, 21.92% neonates were being exposed to 2 donors and 5.48% neonates were exposed to 3 donors. Conclusion: Packed red cells are the major component transfused to preterm neonates being admitted in neonatal intensive care unit. Aliquoting from a single donor unit is an important step in the direction of providing safe and effective blood component therapy to neonates.