Evaluation of blood utilization practices in neonates

BACKGROUND: Blood component therapy is a very common intervention practised in newborns. However, transfusions are not without risks, and they should be given only when true benefits outweigh potential risks. Since neonatal physiology varies with the maturity, age, weight and the presence of morbidities, it is difficult to formulate one parameter to guide all transfusion decisions. AIM OF THE STUDY: The aim of the study was to evaluate the appropriateness of various blood components utilized in neonates and to assess the relationship between gestational age, birth weight and APGAR score with transfusion requirements and to evaluate the relationship between storage age of red cells and length of stay. MATERIALS & METHODS: All neonates (up to 28 days), who received transfusion of at least one unit of blood and its components in the Neonatal Intensive Care Unit (NICU) at Institute of Child Health & Hospital for Children were included for a period of one year (September 2016 - August 2017). Transfusion thresholds for packed red cells, platelets, Fresh Frozen Plasma and whole blood given by National Neonatology Forum (NNF) of India, American Association of Blood Banks, British Committee for Standards in Haematology and Evidence based Expert Opinion were used to categorize appropriate transfusions from inappropriate transfusions. Categorization of Gestational Age by WHO & ACOG, Birth Weight by WHO and APGAR score at 5 min by ACOG were used to assess the relationship between these parameters with transfusion requirement of blood components. There is no standard definition for fresh or old RBCs. So, in this study the storage age of red cells <7 days and