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JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
AUDIT OF BLOOD TRANSFUSION PRACTICES IN THE PAEDIATRIC MEDICAL WARD OF A TERTIARY HOSPITAL IN SOUTHEAST NIGERIA.
East African Medical Journal 2013 January
OBJECTIVES: To determine the indications, practices and outcomes of transfusion on children.
DESIGN: A descriptive retrospective study.
SETTING: Paediatric wards of University of Nigeria Teaching Hospital, Enugu, Nigeria.
SUBJECTS: Children one month to 18 years that received blood transfusion.
MAIN OUTCOME MEASURES: Indications for the transfusion, haemoglobin rise, vital signs, duration of transfusion and adverse events.
RESULTS: The two hundred and thirty eight transfusions reviewed were given amongst 95 patients, at a ratio of 2.5 transfusions per patient. The indicators of the transfusion were: malignancy (31.7%), sepsis (15.1%), sickle cell anaemia (12.1%), malaria (10.0%), hyperbilirubinaemia (10.0%), HIV/AIDS (8.3%), nephrotic syndrome (7.2%) and malnutrition (5.4%). Whole blood (56.4%) and sedimented cells (36.3%) were the main types of blood transfused. About 96.4% were transfused appropriate volume of blood. The mean Haemoglobin concentration (Hb) increase was 3.1g/dl and 12.8% of the recipients recorded an Hb increase of 5g/dl. The mean duration of transfusion was 4.6 hours and 59.7% of the transfusions exceeded the recommended four hours. Pulse and respiratory rates returned to normal post transfusion in 26.1 and 21.8% of the recipients respectively. In 10% of the transfusions there were minor adverse events; chills/fever (5.1%), itching (3.4%), hypothermia (1.0%) and vomiting (0.5%).
CONCLUSION: Blood transfusion in this tertiary institution is not common and mainly due to non-communicable diseases. The expected optimal rise in Hb and normalising of vitals sign are not always the case. The duration of most transfusions was unduly prolonged and transfusion-related adverse events are rare.
DESIGN: A descriptive retrospective study.
SETTING: Paediatric wards of University of Nigeria Teaching Hospital, Enugu, Nigeria.
SUBJECTS: Children one month to 18 years that received blood transfusion.
MAIN OUTCOME MEASURES: Indications for the transfusion, haemoglobin rise, vital signs, duration of transfusion and adverse events.
RESULTS: The two hundred and thirty eight transfusions reviewed were given amongst 95 patients, at a ratio of 2.5 transfusions per patient. The indicators of the transfusion were: malignancy (31.7%), sepsis (15.1%), sickle cell anaemia (12.1%), malaria (10.0%), hyperbilirubinaemia (10.0%), HIV/AIDS (8.3%), nephrotic syndrome (7.2%) and malnutrition (5.4%). Whole blood (56.4%) and sedimented cells (36.3%) were the main types of blood transfused. About 96.4% were transfused appropriate volume of blood. The mean Haemoglobin concentration (Hb) increase was 3.1g/dl and 12.8% of the recipients recorded an Hb increase of 5g/dl. The mean duration of transfusion was 4.6 hours and 59.7% of the transfusions exceeded the recommended four hours. Pulse and respiratory rates returned to normal post transfusion in 26.1 and 21.8% of the recipients respectively. In 10% of the transfusions there were minor adverse events; chills/fever (5.1%), itching (3.4%), hypothermia (1.0%) and vomiting (0.5%).
CONCLUSION: Blood transfusion in this tertiary institution is not common and mainly due to non-communicable diseases. The expected optimal rise in Hb and normalising of vitals sign are not always the case. The duration of most transfusions was unduly prolonged and transfusion-related adverse events are rare.
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