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Related Experiment Video

Updated: May 8, 2026

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Published on: March 14, 2017

Changes in transfusion practice over time in the PICU.

Michael D Dallman1, Xinggang Liu, Anthony D Harris

  • 11Division of Pediatric Critical Care Medicine, University of Mississippi School of Medicine, Jackson, MS. 2Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD. 3Department of Pathology, University of Maryland School of Medicine, Baltimore, MD. 4Division of Pulmonary and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA. 5Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|August 22, 2013
PubMed
Summary
This summary is machine-generated.

Pediatric red blood cell (RBC) transfusions in the ICU decreased significantly from 1998 to 2009. Transfusion practices did not change after a key 2007 trial, indicating limited impact on clinical practice.

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Area of Science:

  • Pediatric critical care medicine
  • Transfusion medicine
  • Clinical practice research

Background:

  • Restrictive transfusion strategies have demonstrated efficacy in critically ill children.
  • The influence of major clinical trials on pediatric transfusion practices remains unclear.
  • Long-term trends in intensive care unit (ICU) transfusion practices for children are not well-documented.

Purpose of the Study:

  • To assess temporal trends in pediatric transfusion practices within an ICU.
  • To evaluate the impact of a major pediatric clinical trial publication on transfusion rates.
  • To identify factors associated with red blood cell (RBC) transfusion in critically ill children.

Main Methods:

  • A single-center, retrospective observational study was conducted.
  • Data were collected from critically ill, nonbleeding children (3 days to 14 years) admitted to a pediatric ICU between 1998 and 2009.
  • Exclusion criteria included congenital heart disease, hemolytic anemia, and hemoglobinopathies.

Main Results:

  • Over 5,000 children were analyzed, with 335 receiving RBC transfusions.
  • The overall proportion of transfused patients declined from 10.5% in 1998 to 6.8% in 2009 (p = 0.007).
  • Factors associated with increased transfusion likelihood included neonatal age, respiratory failure, shock, multiple organ dysfunction syndrome, and acidosis.

Conclusions:

  • A significant decrease in the proportion of pediatric ICU patients receiving transfusions was observed between 1998 and 2009.
  • Publication of a major pediatric clinical trial in 2007 did not result in a discernible change in transfusion practices.
  • Higher illness severity and younger age were linked to a greater likelihood of transfusion.