Emergency uncross‐matched blood transfusions in a tertiary neonatal unit

Abstract

This study establishes an ERBT rate of <1 per 1000 births, and 0.14 per 1000 infants received an ERBT as part of newborn delivery room stabilisation. ERBTs are associated with a high mortality rate. This study highlights the need for further research and guidelines that clarify the role of ERBTs in newborn stabilisations.

Evaluating emergency‐release blood transfusion of newborn infants at the Intermountain Healthcare hospitals

“…We found that ERBTs were administered to neonates of all potentially viable gestational ages (≥22 weeks), but most recipients were term or late preterm neonates. We also found that ERBTs were given to a very high‐risk set of neonates; in this report and that from Ireland, and the present report about one‐third of recipients died. In both reports, ERBT recipients of earliest gestational ages had a 69% to 70% death rate.…”

“…ERBT is an uncommon event in neonatology. The incidence of ERBTs was reported to be 9.14 per 10,000 live births at Cork University Maternity Hospital in Ireland, and we observed essentially the same rate, 9.52 of 10,000, in Intermountain Healthcare hospitals that have Level 3 NICUs. However, hospitals with few deliveries are also occasionally faced with the need to emergently transfuse a newborn infant.…”

“…The term neonatal ERTB is our designation for blood products released emergently for a transfusion to a neonate before a crossmatch can be performed, sometimes without a written order, and brought with haste to the clinical unit for immediate transfusion. ERBTs are typically uncrossmatched type O‐negative red blood cells (RBCs), often followed by AB plasma and/or AB platelets . Although this is a critical aspect of neonatal care, minimal data exist on the incidence, circumstances, timing, blood products used, and outcomes of neonates receiving ERBT …”

“…ERBTs are typically uncrossmatched type O‐negative red blood cells (RBCs), often followed by AB plasma and/or AB platelets . Although this is a critical aspect of neonatal care, minimal data exist on the incidence, circumstances, timing, blood products used, and outcomes of neonates receiving ERBT …”

Optimising Intravenous Volume Resuscitation of the Newborn in the Delivery Room: Practical Considerations and Gaps in Knowledge

“…Haemolytic transfusion reactions are rare in newborn infants [49]. We recently reviewed our own practice (Medical Centre, University College Cork, Cork, Ireland) in relation to the administration of emergency un-cross-matched blood in the DR. Over a 5-year period, there were 42,657 births, and 6 infants (1.4/10,000 live births) received an emergency blood transfusion in the DR [50]. Neither delayed cord clamping nor milking was routinely practiced in our DR in this time frame.…”