Red blood cell concentrate transfusion strategies utilised at a tertiary-level paediatric intensive care unit: A descriptive study on impact and cost
S. Afr. j. child health (Online)
; 12(4): 164-169, 2018. ilus
Article
in English
| AIM
| ID: biblio-1270342
Responsible library:
CG1.1
ABSTRACT
Background. Optimal haemoglobin threshold for red blood cell (RBC) transfusions in critically ill anaemic children in a paediatric intensive care unit (PICU) is uncertain.Objective. To describe outcomes and costs associated with different RBC transfusion strategies in anaemic patients admitted to a tertiary PICU in Durban, South Africa.Methods. Transfusion data gathered over a 1-year period were analysed retrospectively. RBC transfusion strategies were classified as restrictive, 'modified liberal' or mixed. The 'modified liberal' group was subdivided into haemodynamically stable or unstable clusters.Transfusion-related effects, comorbidities and mortality were described. Costs associated with RBC transfusions in the various strategy groups were analysed.Results. Over the 118 transfusion records analysed, a restrictive strategy was adopted in 27 cases (22.9%) and a modified liberal strategy was used in 68 cases (57.6%). A mixed strategy was followed in 23 (19.5%) cases. Although mortality was higher in the modified liberal group than in the restrictive group (27.9% v. 11.1%), the difference was not statistically different (p=0.09). There were no differences in the duration of intermittent positive pressure ventilation, length of PICU stay or post-transfusion effects between the restrictive and modified liberal transfusion strategies. A saving of R155 280.15 could have been realised if a restrictive transfusion strategy had been used for haemodynamically stable patients assigned to the modified liberal group. A further R28 988.67 was spent on avoidable after-hours transfusions levies.Conclusion. Adopting a restrictive daytime strategy for RBC transfusions at a PICU could introduceconsiderable cost savings without affecting outcomes:
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Index:
AIM (Africa)
Main subject:
Pediatrics
/
South Africa
/
Blood Substitutes
/
Blood Transfusion
/
Intensive Care Units, Pediatric
Type of study:
Health economic evaluation
Country/Region as subject:
Africa
Language:
English
Journal:
S. Afr. j. child health (Online)
Year:
2018
Type:
Article
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