Incidence and Determinants of Anaemia and Red Blood Cell Transfusions in PICU

AIMS AND OBJECTIVES: To determine the incidence and to characterize the determinants of red blood cell transfusions in critically ill children during prolonged PICU stay.

MATERIAL AND METHODS: A study was conducted on patients admitted to PICU of Govt Medical College Patiala from April 2018 to July 2018. Age, Sex, Chief complaints, General physical, and Systemic examination was noted on predesigned proforma. Haemoglobin, RBC transfusions, and its indications were monitored in each case from day of admission till discharge or death.

RESULTS: A total of 184 children were enrolled (remained for > 48 hours in the PICU). 38% of children were anemic in the PICU (18.5% on admission, 19.5% developed anemia). 26% percent of children received transfusions; 43% of total transfusions were on Days 1-2. Significant predictors of initial anemia development >48hours after PICU admission were age 28 days or younger, presence of shock on admission, having a respiratory comorbid condition. Predictors for receiving RBC transfusion: age 28days or younger, presence of moderate or severe anemia, presence of shock on PICU admission and high mean volume per kg of blood loss from blood draws.

CONCLUSIONS: A significant proportion of critically ill children receive at least one red blood cell transfusion during their PICU   stay. Younger age, presence of anemia, severe critical illness, MODS, and blood draws are the most significant determinants of red blood cell transfusions in PICU.