A SURVEY OF CANADIAN NEONATAL BLOOD-TRANSFUSION PRACTICES

In 1990, the Pediatric Hemotherapy Committee of the American Associati on of Blood Banks developed and distributed a questionnaire addressing neonatal blood transfusion practices. The same questionnaire was subs equently sent to Canadian university-affiliated hospitals (n=92). This report describes the results of the Canadian survey. Seventy-two perc ent (n=66) of institutions contacted responded. Of these 42% (n=28) ha d sufficient experience with neonatal transfusions and provided suffic ient data for analysis. Although the majority of stated practices did follow published guidelines, several areas of variability and/or subop timal practices were identified. With respect to component selection a nd preparation, suboptimal practices included excessive pretransfusion testing, unnecessary routine washing of RBC concentrates for small-vo lume transfusions, routine volume reduction of platelet concentrates a nd the use of suboptimal granulocyte preparations. With respect to tra nsfusion practices, a disturbingly high percentage of respondents indi cated that frozen plasma would be given in situations generally consid ered inappropriate. There was a great deal of variability in the provi sion of blood components at low risk for CMV, in the use of gamma irra diation and in the platelet count used for prophylactic platelet trans fusions. The data collected in this survey provide information concern ing practices that require improvement, identify areas where further r esearch is desirable and provide a basis for comparison with current a nd future neonatal blood transfusion practices. (C) 1997 Elsevier Scie nce Ltd.