Number of Blood Product Transfusions in Premature Infants in Hazrat Rasoul Hospital: Limitations and Problems

Hospitalized neonates are among the groups who are prone to recurrent blood transfusions. Due to neonates’ immune defects and common transfusion problems, blood transfusion complications have risen in neonatal intensive care units. In order to decrease the number of transfusions in premature neonates, new procedures and techniques such as recombinant erythropoietin use, satellite blood bags, and changing transfusions protocols have been recommended in many countries. Since satellite blood bags are not available in Iran and there has been no published study about transfusions in premature infants, a retrospective study was performed in the NICU of Rasoul-e-Akram Hospital to determine the number of blood transfusions, total amount of transfused products and number of donors each infant was in contact with. Patients & In a retrospective study, information was gathered from 144 premature infants under 37 weeks of gestation who were hospitalized in NICU in 2000-2002. 65 infants(45% of hospitalized infants) received at least one blood product. The mean and range of blood transfusion was 1.2 and 0-16 respectively. Thirty-seven infants(26%) had more than one transfusion. There was a significant correlation between gestational age, birth weight, and transfusions. Out of 68 infants with birth weight under 1500 grams, 47 infants needed transfusion(69%), but from 32 infants with weight over 2 kilograms only, 3 infants(9%) had transfusions(P=0.01). 68% of infants under 30 weeks of gestational age had transfusions in comparison to 41% of 31-34 weeks and 16% of 35-37 weeks(P=0.03). There was no correlation between sex of infants, duration and etiology of hospitalization and use of recombinant erythropoietin. As a lot of newborn infants need transfusion during their hospital stay, (45% in our study), and since there is a correlation between blood transfusions and low birth weight and gestational age, we need to find some resolutions for decreasing number of transfusions and number of contacts with different blood donors. Using satellite blood bags(dividing one bag of blood to smaller ones) is a good suggestion which decreases the amount of blood not used in the NICU. In this study, about 3.4% of packed RBCs and 5.5% of FFP had been used and about 95% of all blood products were discarded. Therefore, it is necessary to find a new way for maximum use of this vital product.