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

Abstract

Background and objective: Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods: In this cross-sectional study, all transfused neonates (n=70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results: Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.Conclusions: The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

Direct-Push Blood Transfusion Practice in the Neonatal Unit of a Tertiary Hospital in South-South, Nigeria

“…Multiple small-volume transfusions are often required in most neonatal intensive care units to cater for many pre-term infants who require prolonged hospitalization for various clinical problems including anaemia. Subsequently, exposure to multiple donors in red blood cell transfusion causes concerns due to the high risk of transfusion-transmissible infections [14]. Therefore, to reduce the exposure rate of these vulnerable neonates, and avoid wastage of large volume of blood, single donor program is a remarkable strategy to achieve cost-effective neonatal transfusion [14].…”

“…Subsequently, exposure to multiple donors in red blood cell transfusion causes concerns due to the high risk of transfusion-transmissible infections [14]. Therefore, to reduce the exposure rate of these vulnerable neonates, and avoid wastage of large volume of blood, single donor program is a remarkable strategy to achieve cost-effective neonatal transfusion [14]. The advantage is that, whenever transfusion is required,,an appropriate blood volume from the donor is directly transfused to the recipient neonate.…”