Apheretic platelets are better quality blood components which reduce donor exposure and chances of TTIs to transfusion recipients when compared to the whole blood derived components. Though safe, these apheretic donations are associated with donor adverse events. We evaluated the incidence of such adverse events associated with the modern apheresis procedures that would provide an insight as well as help formulating preventive steps to avoid frequent occurrences of such events. This prospective audit-based observational study was conducted over 1 year. Donors for plateletpheresis were selected as per the standard operating procedure of the Apheresis Lab. The apheresis procedures were done on the MCS? (Haemonetics Corp.), Trima Accel (Terumo BCT) and COM.TEC (Fresenius Kabi AG). 1740 apheresis procedures were performed, out of which 1708 were plateletpheresis and 32 therapeutic plasma exchange (TPE) procedures for 7 patients. A total of 102 adverse events were noted; of which, 80 (78.43 %) events were associated with donors, 15 (14.71 %) were owed to equipment related problems and 7 (6.86 %) were technical aberrations. All the events associated with donors were mild. No adverse events were reported with any of the 32 TPEs. Apheresis procedures are associated with adverse events which can be reduced by meticulous donor-vigilance, superior training modules for the technical personnel and continued supervision of experienced transfusion medicine specialists. Continued efforts towards making the donor's experience with apheresis more pleasant give a forward thrust to the noble vision of preparing a voluntary apheresis donor pool in India.
Blood transfusion is an indispensable part of modern medical and surgical practices. More than 35% of critically ill patients receive transfusion of blood components during their intensive care unit stay. The aim of study is to obtain an information regarding the relationship of platelet concentrate (PC) and fresh frozen plasma (FFP) transfusion on clinical outcome of neonates admitted in neonatal ICU (NICU). This prospective cohort study was conducted from 1st November 2011 to 30th April 2013. The clinical history, blood component details and laboratory parameters were evaluated with clinical outcome. The neonates requiring PC and FFP transfusion were followed up in blood bank for laboratory parameters. Clinical parameters were noted from case file. During the study period, 291 neonates were admitted in NICU. 2 neonates had congenital malformations and thus, were excluded from the study. Of the remaining 289 neonates, 49 neonates received transfusion of platelets and/or FFP. The combined mean donor exposure for all components was found to be 1.48. The mean volume of PC and FFP transfused was 20 ml and 30 ml respectively. The mean pre-and posttransfusion platelet count was 34,000 ll and 42,000 ll respectively. The mean pre-and post-transfusion INR was 2.37 and 1.53 respectively. There was a significant increase in platelet count and decrease in INR in transfused neonates. However, no clinical benefit of PC and FFP transfusion seen on bleeding. Transfusion of PC and FFP has significant effect on laboratory parameters as compared to clinical parameter.
Red cells are the most often transfused blood components during the neonatal period. The aim of the present study was to obtain information regarding the relationship of red cell transfusion with clinical outcomes and to evaluate red cell transfusion practices in neonatal centre of a tertiary care centre. The clinical history, blood component details and laboratory parameters were evaluated with clinical outcomes. The neonates requiring transfusion of red cells were then followed up in the Blood bank for various laboratory parameters. Clinical parameters and clinical outcome were noted from case files. During the study period, 291 neonates were admitted in NICU. 2 neonates were excluded as they were congenitally malformed. Out of 289 admitted neonates, 61 neonates (21.1%) received blood and blood component transfusions. Out of 61 neonates, 20 received red cell transfusions. Mean donor exposure of red cells was 1.2. The mean volume of transfused red cell was 39.6 ml with mean age of red cells was 3.6 days. The mean pre-and post-transfusion Hct was 25.3 and 30.4%, respectively. The most common indication for red cell transfusion was low haemoglobin. There was a significant increase in lactate level and decrease in base excess in transfused neonates. However, no statistically significant correlations were found between transfusions and neonatal weight gain, apnoea, respiratory support and mortality. Transfusion of red cells has significant effect on laboratory parameters as compared to clinical parameters such as weight gain, episodes of apnoea and respiratory support.
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