Diagnostic and Treatment Related Factors Determining Red Cell Transfusion Among Sick Neonates

Abstract

BACKGROUND Red blood cell transfusion in neonates can be affected by diagnosis and treatment. In this research we reasoned those factors. We wanted to evaluate diagnostic and treatment related factors determining red cell transfusion among sick neonates METHODS This was a case control study done on 300 neonates admitted to the Neonatal Intensive Care Unit (NICU) of Sri Avittom Thiruna l Hospital (SATH), Government Medical College, Thiruvananthapuram for a period of one and a half years. Cases were sick neonates transfused with packed red cells. Diagnostic and treatment related characteristics known to be associated with anaemia of prematurity were recorded. It included total number of phlebotomies performed, approximate blood loss per each phlebotomy, use of other blood components, duration of mechanical ventilation, duration of oxygen supplementation, type of antibiotics given, duration of treatment, duration of hospital stay and outcome of the baby. All statistical data were analysed using SPSS software version 16. RESULTS This study was a case control study done in 300 neonates, cases (n=150) and controls (n=150). Mean number of phlebotomies in the case group was 9.5 ± 2.6 and in the control group was 4.5 ± 2.2 and was statistically significant. On analysis, 72.7 % of case group and 27.3% of the control group required mechanical ventilation and was statistically significant. Among the transfused group, 97.3% required oxygen supplementation while only 64.7% in the control group required it and was statistically significant. Mean duration of oxygen supplementation in the transfused group was 10 ±5.7 days and in the non-transfused control group was 5.4 ± 6.4 days and this was statistically significant. Inotropes were administered in 86% of the case group and in 58% of the control group and was significant. The mean duration of administration of inotropes in the study group was 6.5 ± 4.1 days and in the control group was 4.9 ± 5 days and was significant. Duration of hospital stay was significantly higher in the transfused group CONCLUSIONS Mean number of phlebotomies, requirement and duration of mechanical ventilation, mean duration of oxygen supplementation, administration of inotropes, mean duration of administration of inotropes and duration of hospital stay was significantly higher in the transfused group.