Assessment of the prescription of red blood cell concentrates in the pediatric age group

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Author Pina Faria, Joao Carlos Google Scholar
Victorino, Camila Augusta Google Scholar
Suano de Souza, Fabiola Isabel Autor UNIFESP Google Scholar
Saccardo Sarni, Roseli Oselka Google Scholar
Abstract Objective: To verify the adequacy of red blood cell (RBC) prescription to pediatric patients in different sectors of a pediatric hospital. Method: A retrospective study was conducted including 837/990 RBC transfusion requisition forms for children and adolescents (0 to 13 years old) filed in between January 2007 and April 2015 by the pediatricians of the emergency room (ER), infirmary ward and intensive care unit (pICU). Transfusion requisition forms belonging to patients with chronic anemia or acute hemorrhage, as well as incompletes requisition forms, were excluded. Results: Trigger, prescribed volume and subtype of RBC concentrates were adequate in 532 (65.3%), 460 (58.8%) and 805 (96.2%) of the transfusions, respectively. When the clinical picture was considered, prescription adequacy was higher compared to the use of the hemoglobin level alone (70.9% vs. 41%). The pICU had the highest correct trigger percentage (343 [71.6%]

p< 0.001) while the ER showed more often adequate prescribed volumes (119 [66.1%]

p= 0.020). The most common inadequacy regarding volume was that of prescriptions above the recommendation > 15 mL/kg found in 309 cases (36.9%). Thirty-two (32) RBC subtypes were requested and none were consistent with current recommendations. Conclusion: The results obtained in our study showed that RBC transfusion occurred more appropriately when the clinical picture was taken into account at request. There was a tendency to prescribe higher volumes and RBC subtypes without the justification of current protocols. Hemotherapic teachings at undergraduate level and medical residency must be improved.
Keywords Transfusion Medicine
Erythrocyte Transfusion
Child
Prescriptions
xmlui.dri2xhtml.METS-1.0.item-coverage Sao Paulo
Language English
Date 2018
Published in Revista Da Associacao Medica Brasileira. Sao Paulo, v. 64, n. 2, p. 181-186, 2018.
ISSN 0104-4230 (Sherpa/Romeo, impact factor)
Publisher Assoc Medica Brasileira
Extent 181-186
Origin http://dx.doi.org/10.1590/1806-9282.64.02.181
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000429487700017
SciELO ID S0104-42302018000200181 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/54154

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