Blood Transfusions in the Children Emergency Unit of a Tertiary Hospital in Southern Nigeria

Background: Anaemia is a major cause of morbidity and deaths in children resident in many countries of the sub-Saharan region. Blood transfusion in the emergency units, is an important intervention in the management of many of these children. Some deaths occur even before these transfusions can be initiated. It is important to identify the prevalent causes of childhood anaemia necessitating urgent blood transfusions in various localities. Identified causes would guide proactive policies on preventive measures for such illnesses, as well as blood transfusion practices to curb avoidable deaths.

Methods: A six-month retrospective study of all children aged two months to less than 18 years, admitted to the Children Emergency Unit of the University of Uyo Teaching Hospital, (UUTH), Uyo, Nigeria and given a blood transfusion within 24 hours of admission as part of their clinical management. The indications for admission, packed cell volume before transfusion, type of blood product given and outcome were documented for each child.

Results: Of the 446 children admitted within the six-month period, 65 (14.6%) received a blood transfusion within 24 hours of admission. There were 31 males (47.7%) and 34 females (52.3%), with a median age of 4 years. The most common indications for an emergency transfusion, included severe malarial anaemia, complications of sickle cell anaemia and severe sepsis. The mean packed cell volume (%) before transfusion was 16.73 (± 5.59). Settled (or sedimented cells) was mostly used in 36 (55.4%), and fresh whole blood in 29 (44.6%) of transfusions. The outcome was good, with 84.6% of the transfused children being discharged in satisfactory condition.

Conclusion: The greatest indications for transfusion of blood in the children emergency unit of this hospital were severe malarial anaemia, complications of sickle cell anaemia and severe sepsis. Children under five years were the greatest recipients of blood and settled cells was the most used product. The outcome of the transfused children was good. It is important that health facilities caring for children be equipped with adequate facilities to aid the provision of safe blood whenever needed. This would improve treatment outcomes and childhood deaths from anaemia.