Journal article
Hemoglobin Threshold for Blood Transfusion in a Pediatric Intensive Care Unit
Transfusion medicine and hemotherapy, Vol.43(4), pp.297-301
01/01/2016
DOI: 10.1159/000446253
PMCID: PMC5040940
PMID: 27721706
Abstract
Objective: To evaluate the hemoglobin threshold for red cell transfusion in children admitted to a pediatric intensive care unit (PICU). Methods: Retrospective chart review study. Tertiary care PICU. Critically ill pediatric patients requiring blood transfusion. No intervention. Results: We analyzed the charts of all children between 1 month and 21 years of age who received packed red blood cell (PRBC) transfusions during a 2-year period. The target patients were identified from our blood bank database. For analysis, the patients were subdivided into four groups: acute blood loss (postsurgically, trauma, or acute gastrointestinal bleeding from other causes), hematologic (hematologic malignancies, bone marrow suppression, hemolytic anemia, or sickle cell disease), unstable (FiO(2) > 0.6 and/or on inotropic support), and stable groups. We also compared the pre-transfusion hemoglobin threshold in all unstable patients with that of all stable patients. A total of 571 transfusion episodes in 284 patients were analyzed. 28% (n = 160) of transfusions were administered to patients in the acute blood loss group, 36% (n = 206) to hematologic patients, 17% (n = 99) to unstable patients, and 18% (n = 106) to stable patients. The mean pre-transfusion hemoglobin (+/- SD) in all children as well as in the acute blood loss, hematologic, unstable and stable groups was 7.3 +/- 1.20, 7.83 +/- 1.32, 6.97 +/- 1.31, 7.96 +/- 1.37, 7.31 +/- 1.09 g/dl, respectively. The transfusion threshold for acute blood loss and unstable groups was higher compared to hematologic and stable groups (p < 0.001; ANOVA with multiple comparisons). The mean pre-transfusion hemoglobin threshold for stable and unstable patients among all groups was 7.3 +/- 1.3 and 7.9 +/- 1.3 (p < 0.0001), respectively. The observed mortality rate was higher among children who received transfusion compared to other children admitted to PICU. Conclusion: The hemoglobin threshold for transfusion varied according to clinical conditions. Overall, the hemoglobin threshold for transfusion was 7.3 +/- 1.20 g/dl. 2016 S. Karger GmbH, Freiburg
Details
- Title: Subtitle
- Hemoglobin Threshold for Blood Transfusion in a Pediatric Intensive Care Unit
- Creators
- Madhuradhar Chegondi - Miami Children's HospitalJun Sasaki - Miami Children's HospitalAndre Raszynski - Miami Children's HospitalBalagangadhar R. Totapally - Miami Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Transfusion medicine and hemotherapy, Vol.43(4), pp.297-301
- Publisher
- Karger
- DOI
- 10.1159/000446253
- PMID
- 27721706
- PMCID
- PMC5040940
- ISSN
- 1660-3796
- eISSN
- 1660-3818
- Number of pages
- 5
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Stead Family Department of Pediatrics
- Record Identifier
- 9984353929202771
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