Reduction of exposure to blood donors in preterm infants submitted to red blood cell transfusions using pediatric satellite packs

Abstract

OBJECTIVE: In preterm newborn infants transfused with erythrocytes stored up to 28 days, to compare the reduction of blood donor exposure in two groups of infants classified according to birth weight. METHODS: A prospective study was conducted with preterm infants with birth weight <1000g (Group 1) and 1000-1499g (Group 2), born between April, 2008 and December, 2009. Neonates submitted to exchange transfusions, emergency erythrocyte transfusion, or those who died in the first 24 hours of life were excluded. Transfusions were indicated according to the local guideline using pediatric transfusion satellite bags. Demographic and clinical data, besides number of transfusions and donors were assessed. . Logistic regression analysis was performed to determine factors associated with multiple transfusions. RESULTS: 30 and 48 neonates were included in Groups 1 and 2, respectively. The percentage of newborns with more than one erythrocyte transfusion (90 versus 11%), the median number of transfusions (3 versus 1) and the median of blood donors (2 versus 1) were higher in Group 1 (p<0.001), compared to Group 2. Among those with multiple transfusions, 14 (82%) and one (50%) presented 50% reduction in the number of blood donors, respectively in Groups 1 and 2. Factors associated with multiple transfusions were: birth weight <1000g (OR 11.91; 95%CI 2.14-66.27) and presence of arterial umbilical catheter (OR 8.59; 95%CI 1.94-38.13), adjusted for confounders. CONCLUSIONS: The efficacy of pediatrics satellites bags on blood donor reduction was higher in preterm infants with birth weight <1000g.

A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran

“…We demonstrated that usage of the quadruple Pedi-Packs per neonate with a 20-day expiration date can decrease the donor-exposure rate from 3.16 to 1, which shows a 68.13% reduction in exposure (Kerstin et al, Wood et al, Cook et al, Ibojie et al, and Straaten et al had 33%, 30%, 15%, 35.1%, 22% reduction in DE, respectively) [ 10 , 11 , 14 , 16 , 19 ]. Accordingly, several studies succeeded to prove a reduction in donor-exposure rate by replacement of the alternative blood transfusion methods in NICU using diverse donor programs such as the “sterile docking device” [ 18 , 21 ], or pack-sets with 4–8 satellite packs, by dedicating single donor units for just single neonate with increasing the expiration date of RBCs pack [ 14 , 19 , 22 , 23 ].…”

“…However, this duration can be extended to 42 days without adverse effects on pH, hematocrit, and potassium concentration of the stored blood [ 32 , 33 ]. So, we can reserve it for each neonate up to our estimated time interval of transfusions as an expiry date [ 14 , 23 ]. So, whenever transfusion is required, an appropriate blood volume from the labeled donation main unit is transferred into a satellite bag and supplied without further compatibility testing.…”

“…In this method, an appropriate volume is transferred by gravity into connected satellite packs whenever transfusion is required. [ 9 , 14 , 17 – 23 ].…”

“…Single donor program is a remarkable strategy to achieve a cost-effective method of neonatal transfusion, as a saving of $0.5 and $5.54 per transfusion were reported in two various studies, [ 18 , 21 ]. Furthermore, assigning Pedi-Packs as a single donor program using at least 4 satellite packs for up to 35–42 days stored RBCs was reported as a safe, convenient, and effective method for transfusion in neonates in several other cost-effectiveness studies as well [ 9 , 14 , 17 , 19 , 20 , 23 ].…”

A cost-analysis study of using adult red cell packs and Pedi-Packs in Newborn Intensive Care Units in Southern Iran

“…Single donor program is a remarkable strategy to achieve a cost-effective method of neonatal transfusion, as a saving of $0.5 and $5.54 per transfusion were reported in two various studies, (18,21). Furthermore, assigning Pedi-Packs as a single donor program using at least 4 satellite packs for up to 35-42 days stored RBCs was reported as a safe, convenient, and effective method for transfusion in neonates in several other cost-effectiveness studies as well (9,14,17,19,20,23).…”