PURPOSE: Children with parapneumonic effusion (PNE) are prone to anemia due to the effect of the acute illness and blood losses. Since a blood conservation program (BCP) was established at our institution, the hospitalists have occasionally implemented blood conservation measures (BCM) in caring for these children. These measures include microsampling, less frequent draws, blood waste return and occasionally hematinics. We studied the effect of implementation of BCM on the development of anemia and need for transfusion in children with PNE.
METHODS: Retrospective chart review of all patients admitted to the hospital with PNE. Those prior to the launching of the BCP (1997-1999) were designated historical controls (HC). Those who were admitted after (2000-2004) were either Intervention group (I) if they had blood conservation orders on record or simultaneous controls (SC) if they did not.
RESULTS: All groups were similar in age (5.4 ± 4.4yr), weight 25 ± 6kg), initial hemoglobin (11.1 ± 1.5gm) and had similar interventions. The I group (n = 24) compared to the SC group (n = 28) and the HC group (n = 29) had lesser number of phlebotomies (7.6 ± 4, 11 ± 9 & 12.6 ± 12 P 0.36), lesser volume of blood drawn (14.5 ± 8, 18.5 ± 14 & 69 ± 66ml P.001), lesser volume drawn /kg/day (.08 ± .05, .14 ± .33 & .22 ±.24ml P.006). There was also a trend toward lesser HB drop (1.7 ± 1.4, 2.1 ± 1.2 & 2 ± 1.4gm P.37), longer time for that drop to occur (6.1 ± 3.7, 8.5 ± 5.5, 6.9 ± 4.3 days P.31). Despite a similar transfusion threshold in all groups (7.7 ± 4.6gm), there was a trend toward lesser transfusions in the (I) group compared to the SC and HC groups (8.3%, 17.9% & 31% P.11).
CONCLUSION: In children with PNE, implementation of blood conservation measures resulted in lesser blood losses and transfusion needs.
CLINICAL IMPLICATIONS: Blood conservation while caring for children with PNE may decrease the need for transfusions.
DISCLOSURE: Nabil Hassan, None.