Are red blood cell transfusions associated with nosocomial infections in critically ill children?

Although the transfusion of blood products is common practice, its effects on the immune system have not been adequately studied. A prospective cohort study was conducted in critically ill children followed up until their death, transfer or discharge to establish an association between red blood cell transfusions (RBCTs) and nosocomial infections. A nosocomial infection was considered to be post-transfusional if it occurred within 14 days after RBCT. A total of 162 children were included in the study, 35 (21.6%) had a nosocomial infection, and 49 (30.2%) received a RBCT. Among those with a nosocomial infection, a RBCT was more common (48.5% versus 14.9%, OR: 5.4, 95% CI: 2.4-12.6, p < 0.0001) and mortality rate was higher (45.7% versus 10.2%, OR: 7.4, 95% CI: 3.1-18.2, p < 0.0001). The binary logistic regression showed that RBCT was independently associated with nosocomial infections (OR: 4.2, 95% CI: 2.1-20.2, p=0.049). Conclusion: RBCT was associated with increased risk for nosocomial infections.