Transfusion of red blood cells as risk predictor for nosocomial infections in pediatric intensive care units

Abstract

Background: Transfusion of red blood cells (RBCs) is a common intervention in Pediatric Intensive Care Units (PICU) due to anemia occurring in over one-third of children hospitalized there. Objectives: To establish the relation between transfusion of RBCs and nosocomial infections in PICU and evaluate its impact on absolute lymphocytic count. Patients and methods: A case-control study carried out on 200 critically ill children admitted to PICU, of which one hundred received blood transfusion and one hundred did not. All patients underwent history taking and clinical examination. Results: A statistically significant higher prevalence of mechanical ventilation, central venous catheterization, PRISM score and longer PICU length of stay were observed in the transfused group compared with the non-transfused group (P < 0.001). Nosocomial infections were present in 62% patients in the transfused group and in 32% patients in the non-transfused group (P < 0.05), including nosocomial pneumonia, bacteremia, and urinary tract infection. Mechanical ventilation, presence of central venous catheter, number and age of transfused RBCs were risk predictors for nosocomial infections. Lymphopenia was evident in the transfused group. Conclusion: Nosocomial infections are related with red blood cells transfusion in patients hospitalized in PICU. Mechanical ventilation, presence of central venous catheter, number and age of transfused RBCs, and lymphopenia were risk predictors for nosocomial infections.