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Assessing Differential Transfusion Requirements for Children with Congenital Malformations vs. Pediatric Acute
Alin Ionescu1,2, Alexandra Mihăilescu3, Adela Chiriță-Emandi3
1Center for Preventive Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Insights
Pediatric patients with congenital malformations (CMs) show better anemia correction with preoperative blood transfusions than those with acute abdomen (AA). Tailored transfusion strategies are recommended for optimal pediatric surgical care.
Area of Science:
- Pediatric Hematology
- Surgical Anemia Management
- Congenital Malformations
Background:
- Preoperative anemia is common in pediatric surgical patients.
- Congenital malformations (CMs) and acute abdomen (AA) represent distinct patient groups with varying clinical needs.
- The efficacy of preoperative blood transfusions in correcting anemia may differ between these pediatric patient cohorts.
Purpose of the Study:
- To compare the effectiveness of preoperative blood transfusions in correcting anemia in pediatric patients with CMs versus those with AA.
- To investigate potential differences in transfusion response based on underlying pathology.
- To inform optimized transfusion strategies for pediatric surgical patients.
Main Methods:
- Retrospective analysis of 107 pediatric patients undergoing preoperative blood transfusions for anemia.
- Comparison of hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) at admission, 48 hours post-transfusion, and discharge.
- Statistical analysis using Student's t-test, Pearson correlation, and chi-square tests to compare outcomes between CM and AA groups.
Main Results:
- Children with CM had significantly higher baseline HGB and HCT levels compared to those with AA.
- Post-transfusion, patients with CM demonstrated a greater increase in HGB, particularly those with central nervous system defects.
- Anemia correction was less pronounced in children with AA, with peritonitis cases showing a smaller HGB increase.
Conclusions:
- Pediatric patients with congenital malformations respond more effectively to preoperative blood transfusions than those with acute abdomen conditions.
- Findings suggest a need for differential transfusion strategies tailored to the underlying medical condition.
- Optimizing transfusion approaches can enhance clinical outcomes and resource utilization in pediatric surgery.
Background And Objectives:
This retrospective study aimed to evaluate the efficacy of preoperative blood transfusions in correcting anemia for pediatric patients with congenital malformations (CMs) versus those with acute abdomen (AA) conditions. The study hypothesized that the response to transfusions might vary significantly between these groups due to the differences in the underlying pathology and clinical status.
Methods:
The study included 107 pediatric patients admitted to Timisoara 'Louis Turcanu' Emergency Hospital for Children between January 2015 and May 2023, who required blood transfusions for preoperative anemia. Hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) were assessed at admission, 48 h post-transfusion, and at discharge. Statistical analyses, including Student's t-test, Pearson correlation, and chi-square tests, were utilized to compare outcomes between the groups. The study population was divided into 53 children with CM and 54 with AA.
Results:
Initial analyses showed that children with CM had statistically significantly higher baseline HGB (8.54 ± 1.00 g/dL vs. 7.87 ± 1.02 g/dL, p = 0.001) and HCT (26.07 ± 3.98% vs. 23.95 ± 2.90%, p = 0.002) compared to those with AA. Post-transfusion, children with CM exhibited a greater increase in HGB, with the highest increases noted in patients with central nervous system defects (mean increase of 3.67 g/dL, p = 0.038). In contrast, the increases in HGB for children with AA were less pronounced, with the highest being 2.03 g/dL in those with peritonitis (p = 0.078).
Conclusions:
No significant gender differences were noted in response to transfusion. Children with congenital malformations respond more effectively to preoperative blood transfusions compared to those with acute abdomen conditions. These findings suggest that differential transfusion strategies may be required based on the underlying medical condition to optimize the management of preoperative anemia in pediatric patients. Tailoring transfusion approaches according to specific patient needs and conditions could enhance clinical outcomes and resource utilization in pediatric surgical settings.
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