Evidence-based use of blood products

Abstract

Clinical governance requires the introduction of evidence-based practice in all areas of medicine. Variations in transfusion practice in neonatal units in the UK and USA indicate that evidence-based paediatric transfusion practice is not currently practised in many units and, as a result, children are being exposed to transfusion risks without likelihood of clinical benefit. This also places excessive demands on the transfusion services which are faced with escalating costs of providing safe blood and difficulties in recruiting suitable donors. Introduction of restrictive transfusion policies in some neonatal units has been achieved without increase in morbidity and with significant reduction in donor exposure and indicates what can be achieved once the barriers to the introduction of evidence-based transfusion practice can be broken down. Communication, education and increased resources are required in order to change current practices but, more than anything else, paediatricians must be prepared to take the initiative in examining their current practices and modifying these appropriately.