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

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 weighing 1000 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 > or = 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 > or = 1000 g.