Pattern and determinants of blood transfusion in a Nigerian neonatal unit

Ogunlesi, TA; Ogunfowora, OB

doi:10.4103/1119-3077.86783

Cited by 14 publications

(24 citation statements)

References 12 publications

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“…The clinical significance of this post ET drop in haematocrit was not stated and top up transfusion was not done. Contrary to the findings from the studies above [6][7][8], Ballot et al [9] from South Africa did not observe any significant change in haematocrit following double volume ET. Donor blood haematocrit is the major determinant of post ET haematocrit.…”

Section: Introductioncontrasting

confidence: 75%

“…This practice has however rarely been reported in the literature. In a retrospective review Volume 6 Issue 2 -2017 of neonatal transfusions over a period of 12 months at a teaching hospital in South West Nigeria, Ogunlesi et al [6] reported that 37 of 77 (49.3%) babies, who had exchange transfusion for severe neonatal jaundice, also received post exchange top up transfusion. The indications for these top up transfusions were however not stated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can Post Exchange Blood Transfusion Haematocrit Be Predicted in Neonates?

Audu¹,

Mairami²,

Otuneye³

et al. 2017

JPNC

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Background: Double volume exchange transfusion (DVET) primarily treats severe hyperbilirubinaemia; it also corrects coexisting anaemia when donor blood haematocrit is appropriately adjusted. In resource poor countries, blood for exchange transfusion (ET) is limited to fresh whole blood, the haematocrit of which is rarely documented. In Nigeria, top up transfusion is given to correct anticipated post ET anaemia. This practice is a potential cause of hypervolemia, polycythaemia and hyperviscosity. Objectives:We set out to determine the predictability of post ET haematocrit as this could help identify jaundiced babies that will benefit from post-exchange top up transfusion. Subjects and Methods:Severely jaundiced newborn babies exchanged using the hospital standard protocol were prospectively studied. Blood was drawn from baby before commencement and within one hour after completing the procedure for pre and post ET haematocrit respectively. Donor blood haematocrit was also documented. Post ET haematocrit was calculated on the assumption that DVET resulted in 90% replacement of baby's blood. Bland-Altman analysis was done to estimate the level of agreement between calculated and observed post ET haematocrit.Results: Forty out of 56 babies (30 term) met the inclusion criteria and were analyzed. Mean donor haematocrit was 41.2(4.3)%. This was not significantly different from the pre ET haematocrit (39.9(9.0)% P=.366. Pre ET haematocrit was also similar to post ET haematocrit {39.1(3.7)% P=.107}. Estimated haematocrit {40.5(4.1)%} was similar to post ET observed haematocrit. There was a significant level of agreement between observed and estimated haematocrit. Mean difference =-0.887±3.44 (95% CI=-7.8, 6.0: P=.422). Conclusion and Recommendation:It is concluded that post ET haematocrit can be estimated with a reasonable level of accuracy provided the donor blood haematocrit is known. Jaundiced babies should be selectively identified for post exchange transfusion.

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Section: Introductioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Can Post Exchange Blood Transfusion Haematocrit Be Predicted in Neonates?

Audu¹,

Mairami²,

Otuneye³

et al. 2017

JPNC

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“…Within the cesarean section–only studies, placenta previa at 27% (47 of 431) and obstructed labor at 25% (44 of 431) were the leading indications for transfusion. Among newborn babies, WB and RBC products were used in relatively equal measure, and neonatal jaundice and bleeding together accounted for 66% (218 of 477) of the products transfused overall …”

Section: Resultsmentioning

confidence: 99%

“…These 10 studies were used for the primary outcome calculation. The rest of the studies evaluated blood use among specific patient groups: nine studies among pediatric patients only; five on obstetrics and gynecology patients; three among cesarean section deliveries; three among newborn babies; two among elective surgical operations; two exclusively on the use of platelets; two on the use of autologous blood; and one among hepatogastroenterology patients . Most studies made a clear distinction between the number of patients transfused and the number of blood products used for transfusion.…”

Section: Resultsmentioning

confidence: 99%

Blood use in sub‐Saharan Africa: a systematic review of current data

et al. 2019

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“…Anaemia is a common morbidity in the neonatal intensive care unit (NICU) and this arises predominantly from frequent iatrogenic blood draws necessitated by the need for laboratory investigations and monitoring. The high prevalence of haemolytic conditions in Nigeria has also contributed to increased neonatal transfusion rates in the country [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Posttransfusion Haematocrit Equilibration: Timing Posttransfusion Haematocrit Check in Neonates at the National Hospital, Abuja, Nigeria

Audu

Otuneye

Mairami

et al. 2015

International Journal of Pediatrics

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Anaemia is a common morbidity in the NICU and often requires transfusion of packed red blood cells. Haematocrit equilibration following red cell transfusion occurs over time ultimately resulting in a stable packed cell volume (PCV). Knowledge of this equilibration process is pertinent in the accurate timing of posttransfusion (PT) PCV. We conducted a prospective study to determine an appropriate timing for PT PCV estimation on 47 stable anaemic babies at the Neonatal Unit of National Hospital, Abuja. Values of PCV were determined before transfusion and at 1, 6, 12, 24, and 48 hours posttransfusion. Forty of the recruited neonates and young infants were analyzed. Their gestational age range was 26 to 40 weeks. 1-hour PT PCV (48.5% ± 5.5%) was similar to the 6-hour PT PCV (47.8% ± 5.6%) P = 0.516, but both were significantly different from the 12-hour (46.8% ± 5.9%), 24-hour (45.9 ± 5.8%), and 48-hour (45.4% ± 6.2%) PT PCVs. The 12-hour PT PCV was similar to the 24-hour and 48-hour PT PCVs (P = 0.237 and 0.063, resp.). We concluded that, in stable nonhaemorrhaging and nonhaemolysing young infants, the estimated timing of haematocrit equilibration and, consequently, posttransfusion PCV is 12 hours after red blood cell transfusion.

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Pattern and determinants of blood transfusion in a Nigerian neonatal unit

Abstract: The blood transfusion rate in this facility was remarkably high. Improved standard of newborn care and infrastructural support are required to reduce the transfusion rate.

Cited by 14 publications

References 12 publications

Can Post Exchange Blood Transfusion Haematocrit Be Predicted in Neonates?

Can Post Exchange Blood Transfusion Haematocrit Be Predicted in Neonates?

Blood use in sub‐Saharan Africa: a systematic review of current data

Posttransfusion Haematocrit Equilibration: Timing Posttransfusion Haematocrit Check in Neonates at the National Hospital, Abuja, Nigeria

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