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Cost effective use of satellite packs in neonates: importance of birth weight

Abstract

Background: Blood banks split an adult packed red cell bag (usually 250 ml) into 30 ml bags, making a total of eight neonatal “satellite” packs per donor. These packs are then “allocated”/“committed” to be used to serially transfuse a newborn.

Aim: To study transfusion requirements of premature infants in relation to their birth weight and thereby attempt to rationalise the method of dispensing satellite blood packs.

Method: Data on the distribution of neonatal transfusions with respect to weight were obtained retrospectively from unit A (51 infants, 168 transfusions) and unit B (46 infants, 151 transfusions). These data were used to model the effect of different policies on donor exposure and number of unused packs.

Results: Infants weighing less than 1000 g at birth have significantly higher transfusion requirements than those weighing1000 g or more (p = 0.001 (unit A), p = 0.004 (unit B)). Our model predicted a significant reduction in donor exposure if eight packs/infant were allocated to those weighing < 1000 g, and a significant cut in the number of unused packs if four satellite packs/infant were allocated to those weighing ⩾ 1000 g.

Conclusions: It would be safer and cost effective to allocate eight packs/infant to those with birth weights < 1000 g and four packs/infant to those with birth weights ⩾ 1000 g.

  • birth weight
  • transfusion
  • satellite packs
  • low birth weight
  • donor exposure

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    BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health