van Straaten H L, de Wildt-Eggen J, Huisveld I A
Department of Pediatrics, Isala Clinics, Zwolle, The Netherlands.
J Perinat Med. 2000;28(2):122-8. doi: 10.1515/JPM.2000.016.
Reservation of dedicated series of pedipacks, consisting of 3 to 4 units of 70 ml filtered red cell concentrate in additive solution SAGM from 1 donor, may reduce donor exposure. In this prospective efficacy study the benefits, release and expiration of pedipacks (PP) assigned to preterm infants requiring neonatal intensive care are analyzed.
On the basis of clinical assessment of the need for multiple transfusions, 96 preterm neonates (gestational age < 32 wks and/or birth weight < 1500 g) were assigned to either the high risk group (HRG), who were to receive dedicated donor blood units, or the low risk group (LRG). Inclusion criteria for HRG were 1) estimated time of admission > 21 days and 2) expected need for multiple transfusions due to clinical cardiorespiratory instability, prolonged parental feeding or frequent blood sampling. To reduce wastage of donor blood, dedication of donor blood units was limited to 21 days.
50 series (192 PP) were assigned to 42 HRG infants. Two HRG infants received 3 series, 4 received 2 series and 36 received 1 series of PP. Mean transfusion rate was 3.1 PP in the HRG and 0.4 in the LRG. In the LRG 35 of 54 were not transfused, 19 received 1 to 2 PP. In both groups transfused newborns were exposed to 1.1 donors in average. In the HRG of 192 PP, 137 PP (71%) were used within 21 days, and another 30 (16%) before the expiration date < 35 days. Twenty five PP (13%) expired, mainly because of logistical problems in the introduction phase.
Assignment of dedicated PP on the basis of clinical parameters at entry considerably reduces donor exposure in HRG. Wastage of dedicated blood transfusions was reduced by limitation of the dedicated period (21 days). In terms of efficacy, reservation and use of PP can be optimized by standardized administrative measures.
预留专用的小儿血袋系列，每个系列由来自1名献血者的3至4个单位70毫升添加SAGM溶液的过滤红细胞浓缩液组成，这可能会减少献血者暴露。在这项前瞻性疗效研究中，对分配给需要新生儿重症监护的早产儿的小儿血袋（PP）的益处、发放和过期情况进行了分析。
根据对多次输血需求的临床评估，将96名早产儿（胎龄<32周和/或出生体重<1500克）分为高风险组（HRG），即接受专用献血单位的组，或低风险组（LRG）。HRG的纳入标准为：1）预计入院时间>21天；2）由于临床心肺不稳定、长期经肠道喂养或频繁采血而预计需要多次输血。为减少献血浪费，献血单位的专用期限限制为21天。
50个系列（192个PP）分配给了42名HRG婴儿。2名HRG婴儿接受了3个系列，4名接受了2个系列，36名接受了1个系列的PP。HRG的平均输血率为3.1个PP，LRG为0.4个PP。在LRG中，54名中有35名未输血，19名接受了1至2个PP。两组中接受输血的新生儿平均接触1.1名献血者。在HRG的192个PP中，137个PP（71%）在21天内使用，另外30个（16%）在<35天的过期日期前使用。25个PP（13%）过期，主要是因为引入阶段的后勤问题。
根据入院时的临床参数分配专用PP可显著减少HRG中的献血者暴露。通过限制专用期限（21天）减少了专用输血的浪费。在疗效方面，可通过标准化管理措施优化PP的预留和使用。
