Research Article
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Year 2024, Volume: 6 Issue: 1, 11 - 16, 15.01.2024
https://doi.org/10.38053/acmj.1349434

Abstract

References

  • Valentine SL, Bembea MM, Muszynski JA, et al. Consensus recommendations for RBC transfusion practice in critically ill children from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9):884-898.
  • Tyrrell CT, Bateman ST. Critically ill children: to transfuse or not to transfuse packed red blood cells, that is the question. Pediatr Crit Care Med. 2012;13(2):204-209.
  • Napolitano LM, Kurek S, Luchette FA, et al. Clinical practice guideline: red blood cell ransfusion in adult trauma and critical care. J Trauma. 2009;67(6):1439-1442.
  • Napolitano LM. Guideline compliance in trauma: evidence-based protocols to improve trauma outcomes? Crit Care Med. 2012;40(3):990-992.
  • Doctor A, Cholette JM, Remy KE, et al. Recommendations on RBC transfusion in general critically ill children based on hemoglobin and/or physiologic thresholds from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9S):S98-S113.
  • Pollack MM, Patel KM, Ruttimann UE. PRISM III: an updated Pediatric Risk of Mortality score. Crit Care Med. 1996;24(5):743-752.
  • Kneyber MC, Hersi MI, Twisk JW, Markhorst DG, Plötz FB. Red blood cell transfusion in critically ill children is independently associated with increased mortality. Intensive Care Med. 2007; 33(8):1414-1422.
  • Armano R, Gauvin F, Ducruet T, Lacroix J. Determinants of red blood cell transfusions in a pediatric critical care unit: a prospective, descriptive epidemiological study. Crit Care Med. 2005;33(11):2637-2644.
  • Vincent JL, Baron JF, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA. 2002;288(12):1499-1507.
  • Rafique M, Nasir S, Kamran A, Jamal A. Blood product transfusion practices in pediatric critically ill patients at a tertiary care hospital, Pakistan. Pak J Med Sci. 2023;39(4):999-1002.
  • Muszynski JA, Banks R, Reeder RW, et al. Outcomes associated with early rbc transfusion in pediatric severe sepsis: a propensity-adjusted multicenter cohort study. Shock. 2022;57(1):88-94.
  • Atakul G, Ayhan Y, Topal S, et al. Transfusion practice and costs in a reference tertiary pediatric intensive care unit. Pediatr Pract Res. 2021;9(3):114-119.
  • Demaret P, Tucci M, Ducruet T, Trottier H, Lacroix J. Red blood cell transfusion in critically ill children (CME). Transfusion. 2014;54(2):365-375.
  • Goodman AM, Pollack MM, Patel KM, Luban NL. Pediatric red blood cell transfusions increase resource use. J Pediatr. 2003;142(2):123-127.
  • Goobie SM, Gallagher T, Gross I, Shander A. Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version). Paediatr Anaesth. 2019;29(3):231-236.
  • Bateman ST, Lacroix J, Boven K, et al. Anemia, blood loss, and blood transfusions in North American children in the intensive care unit. Am J Respir Crit Care Med. 2008;178(1):26-33.

Association between red blood cell transfusion and mortality in critically ill children: a single-center pediatric intensive care experience

Year 2024, Volume: 6 Issue: 1, 11 - 16, 15.01.2024
https://doi.org/10.38053/acmj.1349434

Abstract

Aims: Our study aimed to evaluate the association of erythrocyte transfusion with mortality and morbidity in critically ill children and to emphasize the importance of the risk it carries.
Methods: A retrospective evaluation of 524 pediatric patients aged 1 month to 18 years who had been admitted between February 2022 to March 2023 at Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, were performed. Children with hemoglobinopathies, and chronic anemia (defined as the presence of anemia for more than 6 weeks) were excluded. Demographic data, clinical variables, and outcome data were analyzed.
Results: The median age was 36.5 (1.0-272.0) months, and 56.1% of the patients were male. The median duration of a pediatric intensive care unit stay was 5 (1-114) days. Respiratory diseases (44.7%) were the most common reasons for admission to the pediatric intensive care unit, followed by, neurological diseases (12.8%)and sepsis (11.3%). Mortality rate was 5.7%. The median baseline hemoglobin level upon admission was 10.5 g/dl (3.2-18.8). Severe anemia (hemoglobin < 7 g/dl was present in 6.1% of all patients. One hundred and sixteen (22.1%) patients were transfused; 61 (11.6%) were transfused only once. A total of 292 packed red blood cells transfusions were administered. Transfused patients required prolonged hospital stays, support for inotropic agents, invasive mechanical ventilation, and extracorporeal treatment and had an excessive mortality rate (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001).
Conclusion: Clinicians should consider that the administration of packed red blood cells transfusions in critically ill patients may have the potential to both raise mortality and provide life-saving benefits during their pediatric intensive care unit stay. As with any treatment with potential side effects, it is essential to reduce the use of unnecessary blood products.

References

  • Valentine SL, Bembea MM, Muszynski JA, et al. Consensus recommendations for RBC transfusion practice in critically ill children from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9):884-898.
  • Tyrrell CT, Bateman ST. Critically ill children: to transfuse or not to transfuse packed red blood cells, that is the question. Pediatr Crit Care Med. 2012;13(2):204-209.
  • Napolitano LM, Kurek S, Luchette FA, et al. Clinical practice guideline: red blood cell ransfusion in adult trauma and critical care. J Trauma. 2009;67(6):1439-1442.
  • Napolitano LM. Guideline compliance in trauma: evidence-based protocols to improve trauma outcomes? Crit Care Med. 2012;40(3):990-992.
  • Doctor A, Cholette JM, Remy KE, et al. Recommendations on RBC transfusion in general critically ill children based on hemoglobin and/or physiologic thresholds from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9S):S98-S113.
  • Pollack MM, Patel KM, Ruttimann UE. PRISM III: an updated Pediatric Risk of Mortality score. Crit Care Med. 1996;24(5):743-752.
  • Kneyber MC, Hersi MI, Twisk JW, Markhorst DG, Plötz FB. Red blood cell transfusion in critically ill children is independently associated with increased mortality. Intensive Care Med. 2007; 33(8):1414-1422.
  • Armano R, Gauvin F, Ducruet T, Lacroix J. Determinants of red blood cell transfusions in a pediatric critical care unit: a prospective, descriptive epidemiological study. Crit Care Med. 2005;33(11):2637-2644.
  • Vincent JL, Baron JF, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA. 2002;288(12):1499-1507.
  • Rafique M, Nasir S, Kamran A, Jamal A. Blood product transfusion practices in pediatric critically ill patients at a tertiary care hospital, Pakistan. Pak J Med Sci. 2023;39(4):999-1002.
  • Muszynski JA, Banks R, Reeder RW, et al. Outcomes associated with early rbc transfusion in pediatric severe sepsis: a propensity-adjusted multicenter cohort study. Shock. 2022;57(1):88-94.
  • Atakul G, Ayhan Y, Topal S, et al. Transfusion practice and costs in a reference tertiary pediatric intensive care unit. Pediatr Pract Res. 2021;9(3):114-119.
  • Demaret P, Tucci M, Ducruet T, Trottier H, Lacroix J. Red blood cell transfusion in critically ill children (CME). Transfusion. 2014;54(2):365-375.
  • Goodman AM, Pollack MM, Patel KM, Luban NL. Pediatric red blood cell transfusions increase resource use. J Pediatr. 2003;142(2):123-127.
  • Goobie SM, Gallagher T, Gross I, Shander A. Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version). Paediatr Anaesth. 2019;29(3):231-236.
  • Bateman ST, Lacroix J, Boven K, et al. Anemia, blood loss, and blood transfusions in North American children in the intensive care unit. Am J Respir Crit Care Med. 2008;178(1):26-33.

Details

Primary Language English
Subjects Pediatric Surgery, Pediatric Intensive Care
Journal Section Research Articles
Authors

Cansu DURAK 0000-0001-6309-8859

Ceyhan ŞAHİN 0000-0003-3101-3915

Publication Date January 15, 2024
Published in Issue Year 2024 Volume: 6 Issue: 1

Cite

AMA DURAK C, ŞAHİN C. Association between red blood cell transfusion and mortality in critically ill children: a single-center pediatric intensive care experience. Anatolian Curr Med J / ACMJ / acmj. January 2024;6(1):11-16. doi:10.38053/acmj.1349434

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