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Appropriate use of blood component in pédiatric patients in a Venezuelan General University Hospital: Cross-sectional study

Abstract:

Transfusion is an expensive technology because it is necessary to guarantee its safety in order to reduce the risks of transfusion-transmitted diseases. There is no research on audits of appropriate use of blood omponent in a pediatric population. Our main objective was to conduct such an audit. A cross-sectional study using the American Association of Blood Bank criteria was conducted. The setting was Ciudad Hospitalaria "Dr. Enrique Tejera", the main public tertiary hospital in Valencia, Venezuela. Data from 404 pediatric patients from the Clinical Medicine and Surgery Departments, Emergency Room, Neonatal Intensive Care, Preterm Room, Non-Sick Neonate Room, and Intensive Care Unit were collected. The main outcome measure was appropriate use of blood component. Prevalence of appropriate use was 60.49% for all departments. Prevalence by department was: 87.8% for Clinical Medicine, 47.4% for Surgery, 65% for Emergency Room, 55.4% for Neonatal Intensive Care, 44.0% for Preterm Room, 51.1% for Non-Sick Neonate Room, and 81.3% for Intensive Care Unit. Prevalence of appropriate use by blood products was: 76% for packed red cell, 83% whole blood, 52.6% for platelets, 38.3% for fresh frozen plasma, and 28.6% for cryoprecipitate. The main conclusions of this study are: 1) the prevalence of appropriate use of blood products was 60.9%; 2) there is a high risk of inappropriate use of platelets, fresh frozen plasma and cryoprecipitate; 3) The Clinical Medicine Department and Intensive Care Unit showed high rates (>80%) of appropriate use of transfusions.