Blood Transfusion Practices in Neonatal Intensive Care Unit at a Tertiary Care Hospital, Guntur, Andhra Pradesh, India: A Retrospective Study

Introduction: Neonates admitted to intensive care frequently require blood transfusions because of their limited physiological reserves, rapid clinical fluctuations, and multiple sampling needs. Understanding existing transfusion trends is essential to ensure evidence-based and rational use of blood components in this vulnerable group. Aim: To evaluate blood transfusion practices in the NICU by analysing indications, utilisation patterns, and outcomes of blood component administration. Materials and Methods: This retrospective observational study was conducted in the Neonatal Intensive Care Unit and the Department of Pathology and associated blood centre at Guntur Medical College and Government General Hospital, Guntur, Andhra Pradesh, over one year (August 2024 to July 2025). The study included 190 neonates who received at least one blood component transfusion. Neonates admitted during the same period without any transfusion exposure were excluded. Demographic details, birth weight, gestational age, clinical diagnosis, type and frequency of components transfused, timing of transfusion, and documented indications were obtained from NICU records and blood centre archives. Data were analysed using Microsoft Excel 2020 and Statistical Package for Social Sciences (SPSS) version 26.0, with categorical variables summarised as frequencies and percentages, and continuous variables as mean±standard deviation. Results: Out of the 190 neonates, the mean age at first transfusion was 2.5±0.8 days, with 58.9% males. Very low-birth-weight infants constituted the largest subgroup requiring transfusion (87 neonates, 45.8%). Packed red blood cells were the most frequently administered component (158 transfusions, 50.6%). No major transfusion-related adverse events were observed. Inappropriate transfusions accounted for 8.4% of cases. Conclusion: The findings of the present study highlight a predominant transfusion burden among low birth weight neonates. Continuous monitoring and periodic audit of neonatal transfusion practices help ensure rational and safe use of blood components.