An audit of the practice of red packed cell transfusion in neonatal surgery in an academic hospital

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dc.contributor.authorGovender, Kushal
dc.date.accessioned2024-03-13T10:07:06Z
dc.date.available2024-03-13T10:07:06Z
dc.date.issued2024
dc.descriptionA research report submitted in partial fulfilment of the requirement for the degree of Master of Medicine (MMed) in Anaesthesiology to the Faculty of Health Sciences, University of the Witwatersrand, School of Clinical Medicine, Johannesburg, 2023
dc.description.abstractBackground: Neonates undergoing surgery are at greater risk of requiring red packed cells transfusion. Pediatric transfusion practices vary widely between countries and institutions, especially in the management of neonates. Aims: The aim of this study was to describe the practice of intraoperative red packed cells transfusion primarily, and blood products and fluid transfusion secondarily in neonates presenting for surgery. Methods A retrospective contextual and descriptive study was conducted at Chris Hani Baragwanath Academic Hospital. A total of 1077 anesthetic records of neonates who underwent surgery from 1 January 2015 to 31 December 2019 were reviewed. Descriptive and inferential statistics were used to analyze the data. Results: Three hundred and twenty seven (30%) neonates received intraoperative red packed cells transfusion. The median (IQR) volume of red packed cells, fresh frozen plasma, platelets and clear fluid administered was 15 (10 - 21.8) ml/kg, 12.3 (10 - 23.5) ml/kg, 13.6 (10 - 20.5) ml/kg and 19 (9.1 - 28.8) ml/kg respectively. Very low weight, low preoperative hemoglobin, long total anesthetic time, emergency surgery and major surgery were independently associated with blood product transfusion. Post-conceptional age, low and very low weight, blood product transfusion and major surgery were independently associated with the composite adverse outcomes. 3 Conclusions: Intraoperative blood product transfusion occurred up to three times more frequently in our study than in comparative studies. Weight-based dosing of red packed cells, blood products and clear fluids were in keeping with current recommendations. Further prospective cohort studies are recommended to inform an institution specific patient blood management program.
dc.description.librarianTL (2024)
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/37851
dc.language.isoen
dc.rights.holderUniversity of the Witwatersrand, Johannesburg
dc.schoolSchool of Clinical Medicine
dc.subjectBlood transfusion
dc.subjectInfant
dc.subjectNewborn
dc.subjectSurgery
dc.subject.otherSDG-3: Good health and well-being
dc.subject.otherSDG-16: Peace, justice and strong institutions
dc.titleAn audit of the practice of red packed cell transfusion in neonatal surgery in an academic hospital
dc.typeDissertation
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