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Published on: March 14, 2017
Red blood cell transfusion in critically-ill children and its association with outcome
Hafsa Sohail1, Shah Ali Ahmed2, Parveen Usman3
1Department of Pediatrics, Ziauddin Hospital, Karachi, Pakistan.
Insights
Packed red blood cell transfusions in pediatric intensive care were examined. The study found no association between these transfusions and improved patient outcomes.
Area of Science:
- Pediatric Intensive Care Medicine
- Transfusion Medicine
- Hematology
Background:
- Packed red blood cell (PRBC) transfusions are common in pediatric intensive care units (PICUs).
- Evidence regarding the association between PRBC transfusion and outcomes in critically ill children is limited.
- Determining optimal transfusion thresholds is crucial for patient management.
Purpose of the Study:
- To investigate the indications for PRBC transfusions in a PICU setting.
- To identify the hemoglobin thresholds used for PRBC transfusion.
- To assess the association between PRBC transfusion and patient outcomes in a PICU.
Main Methods:
- Retrospective study of medical records from a PICU.
- Included inpatients aged 1 month to 16 years who received PRBC transfusions between January and December 2017.
- Data analysis using SPSS 22.
Main Results:
- 147 patients received PRBC transfusions; common indications were low hemoglobin (61.2%), shock (19.7%), and hypoxia (19%).
- 88% of patients survived, but mechanical ventilation and inotropic support were common.
- PRBC transfusion was not associated with favorable outcomes; higher Pediatric Risk of Mortality scores and need for interventions correlated with mortality.
Conclusions:
- PRBC transfusion is frequently prescribed in PICUs.
- This study did not find an association between PRBC transfusion and improved outcomes in critically ill children.
- Further research may be needed to establish optimal transfusion strategies in pediatric critical care.
Objective:
To determine the indications and threshold of haemoglobin levels for packed red blood cell transfusion and its association with outcomes in a paediatric intensive care setting.
Methods:
The retrospective study was conducted in the paediatric intensive care unit of the Aga Khan University Hospital, Karachi, and comprised medical records of all inpatients with age between 1 month and 16 years who received packed red blood cell transfusions between January and December 2017. Data was retrieved from the hospital database and was analyzed using SPSS 22.
Results:
Of the 147 subjects with a mean age of 67.89±65.8 months, 76(51.7%) were males. Mean paediatric risk of mortality score was 11.72±7.86. Major admitting diagnosis included sepsis and multiorgan dysfunction 50(34%), respiratory diseases 26(17.7%) and haematology/oncology diseases 22(15%). The indications for transfusion was low haemoglobin in 90(61.2%) patients, shock 29(19.7%) and hypoxia 28(19%). Acute transfusion reaction was observed in 1(0.7%) patient; 120(82%) required mechanical ventilation; and 94(64%) required inotropic support. Of the total, 88(59.9%) patients survived. Paediatric risk of mortality score, need for inotropic support and mechanical ventilation were associated with mortality (p<0.05).
Conclusions:
Packed red blood cell transfusion, which is frequently prescribed in intensive care settings, was not found to be associated with favourable outcome.
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