Journal article
Red cell transfusion practices after stage 1 palliation: a survey of practitioners from the Pediatric Cardiac Intensive Care Society
Cardiology in the young, Vol.29(12), pp.1452-1458
12/2019
DOI: 10.1017/S1047951119002385
PMID: 31722769
Abstract
Neonates may require increased red cell mass to optimise oxygen content after stage 1 palliation; however, data informing transfusion practices are limited. We hypothesise there is a patient-, provider-, and institution-based heterogeneity in red cell transfusion decision-making after stage 1 palliation.
We conducted an online survey of Pediatric Cardiac Intensive Care Society practitioners in 2016. Respondents answered scenario-based questions that defined transfusion indications and identified haematocrit transfusion thresholds. Respondents were divided into restrictive and liberal groups based on a haematocrit score. Fisher's exact test was used to determine the associations between transfusion likelihood and patient, provider, and institutional characteristics. Bonferroni correction was applied to adjust the p-value to 0.004 for multiple comparisons.
There was a 21% response rate (116 responses). Most were male (58.6%), attending physicians (85.3%) with >5 year of intensive care experience (88.7%) and subspeciality training in critical care medicine (47.4%). The majority of institutions were academic (96.6%), with a separate cardiac ICU (86.2%), and performed >10 stage 1 palliation cases annually (68.1%). After Bonferroni correction, there were no significant patient, respondent, or institutional differences between the restrictive and liberal groups. No respondent or institutional characteristics influenced transfusion decision-making after stage 1 palliation.
Decision-making around red cell transfusion after stage 1 palliation is heterogeneous. We found no clear relationships between patient, respondent, or institutional characteristics and transfusion decision-making among surveyed respondents. Given the lack of existing data informing red cell transfusion after stage 1 palliation, further studies are necessary to inform evidence-based guidelines.
Details
- Title: Subtitle
- Red cell transfusion practices after stage 1 palliation: a survey of practitioners from the Pediatric Cardiac Intensive Care Society
- Creators
- Aditya Badheka - University of IowaPriscilla Yu - The University of Texas Southwestern Medical CenterFelina Mille - Children's Hospital of PhiladelphiaDennis Durbin - Nationwide Children's HospitalOkan Elci - Children's Hospital of PhiladelphiaJoshua Blinder - Children's Hospital of Philadelphia
- Resource Type
- Journal article
- Publication Details
- Cardiology in the young, Vol.29(12), pp.1452-1458
- DOI
- 10.1017/S1047951119002385
- PMID
- 31722769
- ISSN
- 1047-9511
- eISSN
- 1467-1107
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984353939002771
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