Henrica L. M. van Straaten, Jannie de Wildt-Eggen, Inge A. Huisveld
Evaluation of a strategy to limit blood donor exposure in high risk premature newborns based on clinical estimation of transfusion need
Objectives: Reservation of dedicated series of pedipacks,
consisting of 3 to 4 units of 70 ml filtered red
cell concentrate in additive solution SAGM from 1 donor,
may reduce donor exposure. In this prospective efficacy
study the benefits, release and expiration of pedipacks
(PP) assigned to preterm infants requiring neonatal
intensive care are analyzed.
Methods: On the basis of clinical assessment of the
need for multiple transfusions, 96 preterm neonates
(gestational age < 32 wks and/or birth weight
<1500 g) were assigned to either the high risk group
(HRG), who were to receive dedicated donor blood
units, or the low risk group (LRG). Inclusion criteria
for HRG were 1) estimated time of admission > 21
days and 2) expected need for multiple transfusions due
to clinical cardiorespiratory instability, prolonged parental
feeding or frequent blood sampling. To reduce
wastage of donor blood, dedication of donor blood units
was limited to 21 days.
Results: 50 series (192 PP) were assigned to 42 HRG
infants. Two HRG infants received 3 series, 4 received
2 series and 36 received 1 series of PP. Mean transfusion
rate was 3.1 PP in the HRG and 0.4 in the LRG. In
the LRG 35 of 54 were not transfused, 19 received 1 to
2 PP. In both groups transfused newborns were exposed
to 1.1 donors in average. In the HRG of 192 PP, 137
PP (71%) were used within 21 days, and another 30
(16%) before the expiration date < 35 days. Twenty
five PP (13%) expired, mainly because of logistical
problems in the introduction phase.
Conclusion: Assignment of dedicated PP on the basis
of clinical parameters at entry considerably reduces donor
exposure in HRG. Wastage of dedicated blood
transfusions was reduced by limitation of the dedicated
period (21 days). In terms of efficacy, reservation and
use of PP can be optimized by standardized administrative
measures.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 28, 04/2000
Pages: 122 - 128
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