Blood Transfusion In Surgical Children: The Advantages And Hazards

Abstract

The increasing opposition to blood transfusion makes the management of surgical children who require blood very challenging. This retrospective study reviews records of blood transfusion so as to determine the advantages and hazards in surgical children. The advantages and hazards of blood transfusion in surgical children over 28 years, 1980-2008, at the Paediatric Surgical Ward of the University of Benin Teaching Hospital,
Nigeria, were retrospectively analyzed. Of a total 12,320 children aged between 2 days and 16 years (mean 6 ± 5.4 years) comprising 8100 males and 4220 females with male/female ratio 1.9:1, 820 (6.7%) had
851 sessions of blood transfusion. Blood loss following trauma, burns and intraoperative losses were the major indications for transfusion. Adequate screening of donors’ blood, grouping/cross matching, proper labeling, careful dispensing and strict monitoring during blood transfusion were adhered to during the period. Overall, 801 (97.7%) children recorded rapid improvement in clinical conditions, low wound sepsis and early discharged compared to 87 (10.6%) with similar surgical diseases who were refused
transfusion (P<0.0121). Minor hazards such as irritability at the sight of blood recorded in 39 (4.7%) children, thrombophlebitis at site of transfusion 25 (3%), febrile reaction 8 (1%) and circulatory overload 3 (0.4%) resolved spontaneously without sequel. There
were no significant statistical differences observed when the advantages and hazards recorded were compared between pre-, intra- and postoperative blood transfusions (P<0.6731).
Blood transfusion was advantageous in managing surgical children. Thorough screening of donors’ blood, adequate grouping and cross matching, proper labeling, dispensing and strict monitoring during blood transfusion are advocated in reducing associated hazards.

Keywords: Blood Transfusion, Surgical Children, Advantages, Hazards.