Publication: Red Blood Cell Transfusion Among Neonatal Sepsis Patients At Hospital Usm
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Date
2022-05
Authors
Misran, Siti Marlina
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Abstract
INTRODUCTION: The prevalence of neonatal sepsis varies in different countries. It is one of the most common reasons for admission to NICU, and it remains a significant cause of neonatal morbidity and mortality. Neonates represent a frequent group of recipients receiving red blood cell (RBC) transfusion. However, there is limited information about the impact of RBC transfusion among neonates with sepsis in Malaysia. The risk and potential adverse associations with RBC transfusions are poorly described in neonates. This study aimed to explore the clinical characteristics of neonatal sepsis, evaluate the outcomes related to RBC transfusion and assess the factors associated with mortality in neonatal sepsis. METHODS: This case-control retrospective study involved 220 neonates admitted with sepsis in NICU Hospital USM from 2014 until 2019. The association between patients' demographics, clinical characteristics and RBC transfusion with mortality was analysed by logistic regression. RESULTS: Only half (59.5%) of the neonates were delivered prematurely with a gestational age of fewer than 3 7 weeks. Low birth weight neonates were found to have a higher risk for RBC transfusion, with a mean birth weight of2.34 kg. Among 55 (25.0%) neonates who had proven blood culture positive, 43 (39.1 %) of them had RBC transfusion. There were two (1.8%) reported cases of acute transfusion reaction among neonatal sepsis with RBC transfusion. The mean length of stay in NICU for neonatal sepsis with RBC transfusion was prolonged, up to 15 days compared to neonatal sepsis without RBC transfusion, up to 8 days only. About 71 (32.2%) neonates died during hospitalization in the NICU, of which 55 (50.0%) of them were among neonatal sepsis in transfuse group. Mortality among neonatal sepsis was significantly associated with proven positive blood culture, neonatal birth weight and the total number of RBC transfusions, either with two or more than two RBC transfusions (p<0.05). CONCLUSION: Our study was able to prove that proven positive blood culture, neonatal birth weight and the total number of RBC transfusions were significantly associated with mortality among neonatal sepsis. This information can be utilised by clinicians to ensure that any blood transfusion decision is made judiciously in neonates. Regular clinical audit on blood transfusion and appropriate Patient Blood Management among neonates able to reduce neonatal sepsis morbidity and mortality
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Red Blood Cell Transfusion , Patients At Hospital , Siti Marlina , Universiti Sains Malaysia , AMDI