A prospective observational study to evaluate the blood transfusion practices in pediatrics surgeries at a tertiary care cancer institute in India

Availability of safe and adequate blood supply is a public health challenge especially in low resource settings( country like India).(1) During surgeries, accounting for surgical blood loss and various clinical and laboratory values, transfusion of packed red blood cells (PRBCs) is often necessary to maintain hemodynamic stability and oxygen delivery.(2) Although blood is prescribed for many reasons based on firm belief that it improves oxygen carrying capacity, it carries many adverse hazards.(3) Also paediatric transfusions are different from adult transfusions with respect to indications, transfusion triggers, doses, frequency of adverse reactions. This becomes even more critical in paediatric patients with cancer. However, Transfusions are also known to be associated with multiple risks in children (including allergic reactions, transfusion-associated lung injury (TRALI), immunological risks, Hepatitis B and C and  HIV infection). The risk for occurrence of an adverse event such as a mistransfusion after allogenic blood transfusion is 1.3 times higher in children 1 year and older and 2.8 times higher in newborns (excluding premature infants) compared to adults.(4) Also, the rates of allergic reactions, febrile non haemolytic reactions, and acute haemolytic reactions are much higher in children than in adults. Thus, data on usage and patterns of blood transfusion is extremely important for rational usage of this scarce resource.

Our study aims to evaluate the utilisation of intraoperative blood transfusion in paediatric patients undergoing oncological surgery at a tertiary care cancer institute in India.