Efficacy, safety and cost-efficiency of using an alternative technique for automated exchange transfusion in pediatric patients with sickle cell disease.
BACKGROUND
Sickle cell disease (SCD) patients suffer complications requiring simple and/or exchange transfusion. In 1999 we developed an automated exchange technique using infusion pumps and vascular catheters (IV Pump Method).


OBJECTIVE
To prove that IV Pump Method is cost-efficient, and as safe and effective as automated cell separators.


METHODS
Retrospective chart review of SCD patients requiring exchange transfusion admitted to PICU from 2003-2009. Evaluated method used, complications, costs, and Hemoglobin S% (HgS%) change, excluding patients not requiring exchange transfusion.


RESULTS
Cost-reduction with IV Pump Method is around $1000. Average HgS% reduction using IV Pump Method was 30.3 vs. 28.8 in Blood Cell Separator group (p = 0.84). We had no complications or mortalities, with the majority of patients being male (p = 0.03) and on the oldest age group (11-19 y/o) for both methods.


CONCLUSIONS
The IV Pump Method is a safe, effective, and cost-efficient alternative to perform exchange transfusion.
Villar Prados
Maria B
MB
Pediatric Critical Care Section, Department of Pediatric, UPR School of Medicine, San Juan, PR 00936-5067. mvillarprados@hotmail.com
García De Jesús
Ricardo
R
Fernández Sein
Alicia
A
Iglesias García
Manuel
M
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005078:Exchange Transfusion, Whole Blood / Q000191:economics* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012449:Safety