Is using one unit per NICU baby outdated?
A medical technologist working in a big football town on one of the Great Lakes writes: "We have an NICU physician who wants us to look into whether we should be assigning one unit of blood for each NICU baby." He asks, in the era of modern nucleac acid testing for Hepatitis and HIV, "is the practice of limiting donor exposure from the past?" He'd like to know what the group feels about using one bag of blood per NICU baby, versus a community unit for many babies. He is interested in knowing which facilities assign one full unit per baby versus sharing a unit between several babies.
Editors' note: For facilities reluctant to respond for liability issues, the editors will be happy to anonymize before posting.
The following comments have been received in response:
ADDENDA Nov. 9, 2010
- A large Southern California medical center reports that they have a standing order with their blood provider to receive 1 group O Rh Positive and 1 group O Rh Negative 'pediatric RBC unit' twice each week, (on Tuesday. and Friday). Their current practice is to assign multiple babies to the freshest unit in the inventory on any given day. Thus, if a new baby needed blood on Tuesday, 2 new babies needed blood on Wednesday, and another new baby needed blood on Thursday, they would all be assigned to one of the 2 RBC units received on Tuesday. These babies would remain assigned to that unit until it is used up or it reaches the outdate. The same scenario would follow for the units received on Friday and so on. Should the unit be used up or expire, the babies assigned to that unit would be newly assigned to the freshest unit in the inventory at the time their next transfusion was ordered.
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