Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit

Scot T. Bateman; Jacques Lacroix; Katia Boven; Peter Forbes; Roger P. Barton; Neal J. Thomas; Brian R. Jacobs; Barry P. Markovitz; Brahm Goldstein; James Hanson; H. Agnes Li; Adrienne G. Randolph

doi:10.1164/rccm.200711-1637oc

June 18, 2008American Journal of Respiratory and Critical Care Medicine

Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit

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Key Points

To characterize the development of anemia, volume of blood loss, and frequency of red blood cell transfusions and evaluate their association with clinical outcomes in critically ill children.
Prospective, multicenter, 6-month observational study conducted across 30 pediatric intensive care units (PICUs).
Enrolled 977 consecutive pediatric patients younger than 18 years who remained in the PICU for 48 hours or more.
Anemia affected 74% of patients (33% present on admission, 41% acquired during stay), with laboratory blood draws accounting for 73% of daily blood loss (median loss of 5.0 ml/day).
Red blood cell transfusions were administered to 49% of children and were independently associated with higher mortality (OR, 11.6; 95% CI, 1.43–90.9; P = 0.02), nosocomial infections (OR, 1.9; 95% CI, 1.2–3.0; P = 0.004), and cardiorespiratory dysfunction (OR, 2.1; 95% CI, 1.5–3.0; P < 0.001).
Transfused patients required significantly more days of mechanical ventilation (difference of 2.1 days, P < 0.001) and longer PICU stays (difference of 1.8 days, P = 0.03).

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Implication

Prospective multicenter observational study reveals blood transfusions increase mortality and morbidity in critically ill children, highlighting the need to minimize diagnostic blood loss.

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Bateman et al. (2008) studied this question.

synapsesocial.com/papers/6a168d5c66334ab13b050111 https://doi.org/10.1164/rccm.200711-1637oc

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Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit

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Anemia, Blood Loss, and Blood Transfusions in North American Children in the Intensive Care Unit

Key Points

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