Pediatric transfusion practices: A single-center retrospective study

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 18; no. 11; pp. 1154 - 1161
• Main Authors: Navarro, C, Ducher, E, Tas, H, Chabre, C, Deméocq, F, Fabrigli, P, Kanold, J, Merlin, E
• Format: Journal Article
• Language: French
• Published: France 01-11-2011
• Subjects: Adolescent; Blood Transfusion - standards; Child; Child, Preschool; Female; Guideline Adherence - statistics & numerical data; Humans; Infant; Infant, Newborn; Male; Practice Patterns, Physicians; Retrospective Studies; Young Adult
• ISSN: 1769-664X
• DOI: 10.1016/j.arcped.2011.08.010

This study aimed to describe the professional practices in pediatric transfusion to assess the accuracy of transfusion guidelines in children.
The study retrospectively analyzed the characteristics of all the pediatric transfusions prescribed in the Clermont-Ferrand (France) university hospital center over 1 year and determined whether they conformed to the national guidelines.
One thousand six hundred and seven blood products were delivered to 233 children (806 red cell units, 670 platelet units, and 131 plasma units), accounting for 5.3% of the center's whole blood products. Transfusions were mainly prescribed by the oncohematology unit (68.2%), the intensive care unit (15.4%), and for surgery (10.2%). Ten adverse events were reported in eight patients (0.6% of transfusions). The prescription conformed to the national guidelines in 35.9%, 41.6%, and 80.9% of the red blood cell, platelet, and plasma unit transfusions, respectively. Nonconformity was mainly due to abusive irradiation and "cytomegalovirus seronegative" specifications.
Malignancies, intensive care, and surgery are the main indications for transfusion in children. Substantial discrepancy between recommendations and actual practices was observed. This illustrates the variability of risk evaluation. This should be made simpler by the use of photochemical pathogen inactivation techniques.