Related Experiment Video
Updated: Jan 3, 2026
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Red cell transfusion practices after stage 1 palliation: a survey of practitioners from the Pediatric Cardiac
Aditya Badheka1, Priscilla Yu2, Felina Mille3
1Division of Critical Care, Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA.
Insights
Red blood cell transfusions after stage 1 palliation show varied decision-making among practitioners. This study found no clear links between patient, provider, or institutional factors and transfusion choices, highlighting a need for evidence-based guidelines.
Area of Science:
- Pediatric Cardiology
- Neonatal Intensive Care
- Transfusion Medicine
Background:
- Neonates undergoing stage 1 palliation may need increased red blood cell mass to optimize oxygen delivery.
- Current data guiding red blood cell transfusion practices in this population are limited.
- Hypothesized heterogeneity exists in transfusion decision-making based on patient, provider, and institutional factors.
Purpose of the Study:
- To investigate heterogeneity in red blood cell transfusion decision-making among practitioners caring for neonates after stage 1 palliation.
- To identify patient, provider, and institutional characteristics associated with transfusion practices.
Main Methods:
- An online survey was distributed to Pediatric Cardiac Intensive Care Society practitioners in 2016.
- Respondents provided answers to scenario-based questions defining transfusion indications and hematocrit thresholds.
- Statistical analysis, including Fisher's exact test and Bonferroni correction, was used to assess associations.
Main Results:
- A 21% response rate was achieved from 116 practitioners.
- No significant associations were found between patient, respondent, or institutional characteristics and transfusion decision-making after applying Bonferroni correction.
- Neither respondent nor institutional characteristics influenced transfusion decisions in this cohort.
Conclusions:
- Decision-making regarding red blood cell transfusions after stage 1 palliation appears heterogeneous.
- No clear relationships were identified between patient, respondent, or institutional factors and transfusion choices.
- Further research is required to establish evidence-based guidelines for red blood cell transfusion in neonates post-stage 1 palliation.
Introduction:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
More Related Videos
07:24A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
09:54Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
01:28Kidney Transplant I: Introduction