Blood component preferences of transfusion services supporting infant transfusions: a University HealthSystem Consortium benchmarking study.
BACKGROUND
The extent of acceptability of red blood cells (RBCs) containing additive solutions (ASs) for low-volume neonatal transfusions among hospitals is unknown. Also unknown is whether hospitals have policies that address the risk of hyperkalemia associated with prolonged storage either with or without irradiation for neonatal transfusions.


METHODS
A benchmarking survey of University HealthSystem Consortium members included questions regarding the acceptability of RBC units containing ASs for low-volume neonatal transfusions, policies addressing the length of RBC storage in AS, and policies regarding storage periods after irradiation.


RESULTS
Twenty-eight of 47 respondents (60%) accept the use of at least one AS (AS-1, AS-3, or AS-5). Twenty-one (45%) accept the use of all three ASs for neonatal transfusions. Thirty-seven of 45 respondents (82%) do not have a policy requiring washing of RBCs used for low-volume transfusions beyond a specified number of days of storage or days after irradiation.


CONCLUSIONS
Although the majority of institutions will use ASs, a significant number of institutions will not. The reasons for these policies were not elicited. Most respondents did not have a policy requiring washing beyond a specified number of days of storage or days after irradiation. Since RBCs stored for prolonged periods of time after irradiation have increased plasma potassium, it is important to develop policies to prevent clinically significant posttransfusion hyperkalemia in at-risk patients when RBCs are irradiated and not used immediately. More work still needs to be done to resolve these fundamental precepts of neonatal transfusion.
Fung
Mark K
MK
Fletcher Allen Health Care, Burlington, Vermont 05401, USA. mark.fung@vtmednet.org
Roseff
Susan D
SD
Vermoch
Kathleen L
KL
D000925:Anticoagulants / Q000494:pharmacology; D001291:Attitude of Health Personnel; D019985:Benchmarking; D001793:Blood Preservation / Q000379:methods* / Q000592:standards; D058731:Blood Safety; D017848:Blood-Borne Pathogens / Q000528:radiation effects; D002951:Citrates / Q000494:pharmacology; D017707:Erythrocyte Transfusion / Q000379:methods; D004912:Erythrocytes / Q000187:drug effects / Q000528:radiation effects; D005947:Glucose / Q000494:pharmacology; D019538:Health Care Surveys; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced / Q000517:prevention & control; D007223:Infant; D007231:Infant, Newborn; D009359:Neonatology; D019188:Organ Preservation Solutions / Q000494:pharmacology; D011188:Potassium / Q000009:adverse effects / Q000097:blood; D013997:Time Factors; D064826:Transfusion Medicine; D065227:Transfusion Reaction / Q000517:prevention & control
D000925:Anticoagulants; D002951:Citrates; D019188:Organ Preservation Solutions; C007077:citrate phosphate dextrose; D005947:Glucose; D011188:Potassium