NEW TRANSFUSION PROGRAM FOR AN INTENSIVE CARE NURSERY

Abstract

A new transfusion protocol for sick neonates was established in February, 1974, in which units of packed red blood cells obtained biweekly from type O- donors are split into 4 packs. Up to 4 Infants requiring transfusions are crossmatched against a single unit. One split pack is brought to the nursery each day and refrigerated for 24 hours. During the 24 hours, the split pack may be entered as many times as necessary to provide small transfusions for infants crossmatched to the unit. Using this procedure, several infants can receive numerous small transfusions from a single unit for 3-4 days. Over a 16 month period, 191 newborns received 785 transfusions under this system. Of 129 infants who survived and had received transfusions, 91 (71%) were evaluated at a mean age of 10 months for evidence of CMV infection and most for hepatitis B infection and red cell antibody formation. Evidence for CMV infection was found in 18/91 or 20%, compared to 25% in transfused infants at a comparable age in other follow up studies. No transfused infants tested had either hepatitis B antigenemia (0/72) or antibody to hepatitis B core antigen (0/44). One transfused infant of 72 screened had an anti-M antibody. Advantages of this system compared to a walking donor program include immediate availability of blood in the nursery for most sick newborns, quality control in drawing and processing blood by the blood bank and testing for hepatitis B antigen before using blood.