An audit of the use of blood components in acute systemic infections and its correlation with clinical outcome

Abstract

Blood components, especially plasma, are excellent volume expanders but increased osmotic loads draw volume into the intravascular space resulting in volume overload, particularly in patients with cardiac and renal insufficiency. In addition, allogeneic blood transfusion exposes the recipient to large amounts of alloantigen which can create a variety of immunological responses including allo-immunisation and down regulation of immune response. All children between the age of 1 year to 15 years admitted to PICU at our teaching Hospital over a 24 month period with acute systemic infections were evaluated. In our study, of the total of 178 cases, seventy two cases (40%) received fresh frozen plasma for deranged coagulation profile which was considered as an appropriate indication. Eighty two cases (46%) received fresh frozen plasma for hypotension and thirty one cases (17%) for low serum albumin which were both considered as inappropriate indications.Clinical outcome in these two groups of patients showed that there was no significant difference in duration of hospital stay. There was an increase incidence of mortality in children who received FFP for inappropriate indications, though it was not statistically significant (P=0.375). It was also noted that a statistically significant increase in morbidity in the form of increased requirement of ventilatory support for the inappropriately transfused group (P=0.008) was seen in our study.