Does “old blood” transfused in the Neonatal Intensive Care Unit (NICU) lead to poorer outcomes?
 
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Amy Huxtable*, Megan Tombling**, Dr N Maxwell***
Derriford Hospital NICU, Peninsula Medical School*, Derriford Hospital NICU, Peninsula Medical School**, Derriford Hospital NICU, Peninsula Medical School***
The ABLE study published in 2015 in adult intensive care medicine found no difference between “fresh” and “old” blood in terms of overall 90 day mortality rates.(1) When a transfusion is prescribed to a neonate the percentage of their total circulating volume which is given is much higher than in that of adult medicine. Anecdotal observations seemed to suggest an increase in septic screens in those neonates given blood close to the expiry date. Therefore, all neonates (n=74) who required blood transfusions (n=229) over a two year period in Plymouth’s level three NICU were included in a retrospective audit which aimed to establish whether blood transfused close to its expiry date was related to an increase in the number of septic screens or deaths. Preliminary results appear to show that there is no statistically significant relationship between blood that is close to the expiry date in neonates and the number of septic screens or adverse events. This work is similar to that of Ferguson et al. who focused on very low birthweight pre-term neonates who found that “fresh” blood did not improve outcomes in the study population. (2) Therefore it can be concluded based on this sample that blood used throughout its shelf life is safe to use in neonates, in spite of the increased percentage of circulating volume given. This could relieve potential pressures on an already stretched blood donation service.
References :
  1. Lacroix J, Hébert PC, Fergusson DA, Tinmouth A, Cook DJ, Marshall JC, et al. Age of Transfused Blood in Critically Ill Adults. NEJM. 2015;372:1410-8.
  2. Fergusson DA, Hébert P, Hogan DL, et al. Effect of Fresh Red Blood Cell Transfusions on Clinical Outcomes in Premature, Very Low-Birth-Weight Infants: The ARIPI Randomized Trial. JAMA. 2012;308(14):1443-1451

DOI: 10.7199/ped.oncall.2015.7S
 
How to Cite URL :
Huxtable A, Tombling M, Maxwell N D.. Available From : http://www.pediatriconcall.com/conference/abstract/34/view/835
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