Abstract
Background and objectiveSaving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors.MethodsIn this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared.ResultsConsidering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.ConclusionsThe assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.
Highlights
Despite carrying out some effective strategies such as micro methods blood sampling and autologous placental blood transfusion practice [1,2,3] to tackle blood loss in the Newborn intensive care unit (NICU), newborns are highly exposed to blood loss and anemia caused by repeated diagnostic phlebotomies [4, 5]
Subjects In this cross-sectional study, medical charts of all neonates who were admitted to newborn intensive care unit (NICU) of Nemazee Hospital, a tertiary referral hospital in Shiraz, Southern Iran were evaluated between March and June 2019
The mean gestational age, birth weight of the neonates, and the number of days stay in NICU were 33.24 ± 2.52 weeks, 2081 ± 680 gram, and 19.08 ± 18.04 days, respectively, including 39 males (56%) and 31 (44%) females
Summary
Despite carrying out some effective strategies such as micro methods blood sampling and autologous placental blood transfusion practice [1,2,3] to tackle blood loss in the Newborn intensive care unit (NICU), newborns are highly exposed to blood loss and anemia caused by repeated diagnostic phlebotomies [4, 5]. Haghpanah et al Cost Eff Resour Alloc (2021) 19:15 stored up to 35–42 days by use of a sterile connection device. In this method, an appropriate volume is transferred by gravity into connected satellite packs whenever transfusion is required. Due to small-blood volume consumption per transfusion, it results in multiple donors exposure and causes wastage of a large number of blood supplies, as the proportion of 34.7% and 93% RBCs wastage have been reported in NICU and surgery units in different centers in Iran [30, 31]. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors
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