Blood Component Transfusion in Tertiary Neonatal Intensive Care Unit (NICU) and Neonatal Intermediate Care Unit (NIMC): An Audit

Background: Neonates admitted in tertiary Neonatal Intensive Care Unit require multiple blood transfusion due to long NICU stay and repeated sampling. They are at increased risk of infection and other complication.

Methodology: All pre-term and term neonates admitted to NICU and NIMC and who received any transfusion i.e. Fresh Frozen Plasma (FFP), Packed Cell Volume (PCV), Platelets, Exchange transfusion were included. Data was collected from medical records from 2011 to 2016. Analysis was done by descriptive statistics and using Chi-square test.

Results: Out of 340 neonates included, 73.2% (n=249) are low birth weight (LBW). Out of 249 patients, 33 were extremely low birth weight, 77 were very low birth weight and 139 were LBW. 81.5% (n=277) neonates required transfusion during first week of life, 35.9% (n=122) neonates required transfusion on day-1 of life. Majority neonates required multiple transfusion. 4.12 %(n=14) neonates required up to 10 transfusions and two neonates required up to 22 transfusions and 58 neonates require more than five blood transfusion. 15 out of 33 ELBW babies required >/= 5 transfusion, 40 out of 172 LBW neonates required >/= 5 transfusion and 18 Term neonates required >/= 5 transfusion. Statistical correlation was found between neonatal birth weight and multiple transfusion need (p = 0.01). Majority required transfusion due to Neonatal sepsis, Disseminated intravascular coagulopathy, Anemia of prematurity and Unconjugated hyperbilirubinemia. Pre term infant required more transfusion vis-a-vis full term infants. No transfusion related complication were observed in our study. 54.7 % transfusions were Fresh frozen plasma, 24.1% transfusions were Packed cell volume, 15.9% transfusions were platelet concentrate and 5.3% was whole blood.

Conclusion: Majority require transfusion due to Neonatal sepsis, Disseminated intravascular coagulopathy, Anemia of prematurity and Unconjugated hyperbilirubinemia. LBW is also risk factor for multiple blood transfusion. Fresh frozen plasma is the most common blood product transfused.