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Pediatric red blood cell transfusions increase resource use
Allyson M Goodman1, Murray M Pollack, Kantilal M Patel
1Divisions of Critical Care Medicine, Children's Research Institute, George Washington University School of Medicine, Washington, DC 20010, USA.
Insights
Red blood cell transfusions in critically ill children increase resource use, including oxygen, ventilation, and hospital stay. Clinicians should consider this increased morbidity when deciding on transfusions.
Area of Science:
- Pediatric critical care medicine
- Transfusion medicine
- Clinical outcomes research
Background:
- Red blood cell transfusions are common in critically ill children.
- The impact of transfusions on resource utilization and outcomes in this population requires further investigation.
Purpose of the Study:
- To evaluate the association between red blood cell transfusions and resource utilization in critically ill children.
- To determine if transfusions correlate with increased mortality in pediatric intensive care unit (PICU) patients.
Main Methods:
- Retrospective cohort analysis of 240 children across five PICUs from 1996-1999.
- Inclusion criteria: hemoglobin
- Data collected included demographics, hemoglobin levels, blood product use, PICU resource use, and hospital mortality.
Main Results:
- Out of 240 children, 131 received transfusions.
- Transfused children experienced significantly more days of oxygen use, mechanical ventilation, and vasoactive agent infusions.
- Transfusion was linked to longer PICU and hospital lengths of stay.
Conclusions:
- Red blood cell transfusions are associated with increased resource utilization in critically ill children.
- The potential morbidity associated with transfusions should be a key consideration in clinical decision-making.
- Further research may explore optimal transfusion thresholds in pediatric critical care.
Objective:
To test the hypothesis that red blood cell transfusions are associated with increased resource utilization and mortality in critically ill children.
Methods:
Five pediatric intensive care units (PICUs) participated in a retrospective, cohort analysis (1996-1999). Children with a hemoglobin value
Results:
Among 240 children, 131 were transfused and 109 were not transfused. After controlling for the effects of other variables, transfusion was associated with an increase in days of oxygen use (4.48 +/- 1.37 days), days of mechanical ventilation (4.05 +/- 1.10 days), days of vasoactive agent infusions (1.27 +/- 0.44 days), and an increase of PICU and hospital lengths of stay (4.44 +/- 1.32, and 7.75 +/- 2.36 days, respectively).
Conclusion:
Red blood cell transfusions are associated with an increase in resource utilization in critically ill children. The decision to transfuse patients should incorporate this potential morbidity.