Utilisation of Different Blood Components in Paediatric Patients: A Cross-sectional Study

Abstract

Introduction: The term “blood component” refers to the separation of Whole Blood (WB) into packed red cells, platelet-rich plasma, Fresh Frozen Plasma (FFP), cryoprecipitate, and leukocytes. The practice of separating donated WB units into different blood components and supplying only those components to patients is now considered a standard practice in all blood banks. Therefore, regular auditing of blood usage and its components is essential to assess blood utilisation patterns. Aim: The aim of this study was to analyse the distribution and appropriateness of blood and blood product transfusions in children aged 1-18 years. Materials and Methods: A cross-sectional study was conducted over an 18-month period from December 1, 2014, to June 30, 2016, involving paediatric patients requiring blood and blood product transfusions, who presented to the Department of Paediatrics, Shri B.M. Patil Medical Hospital, Vijayapura, Karnataka, India. The study population consisted of children aged 1-18 years. Data from blood component requisition forms were collected, and reports of investigations such as pre-transfusion/post-transfusion haematological parameters, coagulogram, and peripheral smear were recorded. Predetermined criteria were used to assess each transfusion episode. The results were then analysed, tabulated, and expressed as a percentage. The appropriateness of Packed Red Blood Cell (PRBC), platelet, and FFP transfusions was estimated using predetermined criteria. Data from blood component requisition forms were collected, coded, tabulated, analysed, and expressed as a percentage. Results: The study included 149 paediatric patients aged 1 to 18 years. Out of a total of 214 episodes of blood and blood component transfusions among the 149 patients, 102 episodes (47.7%) were WB transfusions, 67 episodes (31.3%) were packed red cell transfusions, 26 episodes (12.1%) were platelet transfusions, and 19 episodes (8.9%) were FFP transfusions. Out of the total 214 transfusion episodes, 126 (58.5%) were deemed appropriate, while 88 (41.5%) were deemed inappropriate. The most commonly inappropriately used component was WB, followed by platelets, FFP, and packed red cells. Inappropriateness of WB usage was primarily due to attempts to achieve haemostasis in bleeding patients, while sepsis was the most common indication for inappropriate platelet usage. Conclusion: This audit highlights significant variation in transfusion practice patterns among paediatricians. The most common indications for usage were found to be achieving haemostasis, threshold haemoglobin concentration, and sepsis in children.

Keywords

• appropriateness
• blood utilisation pattern
• predetermined criteria