Red blood cell prescription and recognition of transfusion reactions by pediatricians

Carlos João Schaffhausser,Fabíola Isabel Suano-Souza,João Carlos Pina Faria,Roseli Oselka Saccardo Sarni

doi:10.31744/einstein_journal/2020ao5446

Carlos João Schaffhausser, Fabíola Isabel Suano-Souza + Show 2 more

Open Access

https://doi.org/10.31744/einstein_journal/2020ao5446

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Abstract

ABSTRACTObjective To assess the level of knowledge of emergency pediatricians on red blood cell transfusions and their reactions.MethodsWritten survey with emergency pediatricians from a pediatric hospital.Results Less than 20% of pediatricians showed appropriate knowledge on prescribing red blood cells and recognition of transfusion reactions. There was no significant statistical regarding time since graduation and blood transfusion classes in undergraduate studies or during medical residency.Conclusion Pediatricians have insufficient knowledge about red blood cell transfusions and recognition of transfusion reactions.

Highlights

Transfusion of red blood cell (RBC) is not exempt from risks
43 (64%) pediatricians had classes on blood transfusion during undergraduate medical course and, of these, 83.7% had less than 2 hours/ class
18 (26.9%) had a class on blood transfusion during medical residency in pediatrics, and 72.2% had less than 2 hours/class

Summary

Introduction

Transfusion of red blood cell (RBC) is not exempt from risks. Several transfusion reactions can occur, some of which are fatal.[1]. Schaffhausser Filho CJ, Faria JC, Suano-Souza FI, Sarni RO weight (kilogram), leads to greater risk of volume overload, which is related to worse outcomes in children.[5] Circulatory overload is one of the three major causes of transfusion-related deaths.[6] Another important decision is choosing the RBC subtype. When anemia is symptomatic or associated with chronic conditions, such as cyanogenic heart disease, lung diseases, etc., the trigger is higher.[1] Sepsis is the major cause of transfusion in symptomatic children in our region and the trigger is 10.0g/dL.[7] The volume of RBC prescribed should be between 10 and 15mL/kg.[1] The main indications for specific RBC subtypes are filtered (immunosuppressed and polytransfused children), irradiated (immunosuppressed and related donors), washed (previous transfusion-related anaphylaxis), and phenotyped (polytransfused patients).(1). Educational measures are proven to improve physicians’ knowledge on transfusion.[11]

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Conclusion