Pediatric Emergency Blood with Effect Transfusion and Prognosis

Abstract

Background: The COVID-19 pandemic has led to a shortage of blood supplies for children, resulting in prolonged waiting times for transfusions. This study aims to explore the effect of timely blood transfusion on the effect and prognosis of blood transfusion in children during the COVID-19 pandemic. Methods: This retrospective cohort study included children who were indicated for blood transfusion in the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center between January 2020 and December 2020. The outcomes were the effect and the final clinical outcomes of blood transfusion. Results: This study included 260 children with non-traumatic non-surgical low Hb: 209 with timely transfusion, 40 with delayed transfusion, and 11 without transfusion; 80% of children were below 60 g/L (min 17 g/L), and the waiting time for transfusion within 100.5 hours (P < 0.001 among the three groups). Among 249 patients receiving blood transfusions, overall efficiency was 33.33%. There were no differences in the change in Hb value after transfusion (P = 0.205). The Hb improvement refractory group received more washed red blood cell suspensions (P = 0.044), lower post-transfusion Hb values (P < 0.001), and a smaller change in Hb value (P < 0.001) compared with the successful group. Timely transfusion rates (70% vs. 86.6% P = 0.009) and post-transfusion Hb values were smaller (64 vs. 78 g/L, P < 0.001); the post-transfusion Hb threshold of hypoxia improvement was 61.5g/L [Sensitivity: 47.5%, Specificity: 90.4%, AUC: 0.737, P < 0.001]. Conclusions: During the 100-h waiting time, there were no significant differences in outcomes among the timely, delayed, and no transfusion groups. A timely blood transfusion may not affect the clinical outcomes of children.