Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit

Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit

Abstract Background We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion...

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Veröffentlicht in:Journal of tropical pediatrics (1980) 2018-04, Vol.64 (2), p.118-125
Hauptverfasser: Akyildiz, Basak, Ulgen Tekerek, Nazan, Pamukcu, Ozge, Dursun, Adem, Karakukcu, Musa, Narin, Nazmi, Yay, Mehmet, Elmali, Ferhan
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container_end_page 125
container_issue 2
container_start_page 118
container_title Journal of tropical pediatrics (1980)
container_volume 64
creator Akyildiz, Basak
Ulgen Tekerek, Nazan
Pamukcu, Ozge
Dursun, Adem
Karakukcu, Musa
Narin, Nazmi
Yay, Mehmet
Elmali, Ferhan
description Abstract Background We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger 
doi_str_mv 10.1093/tropej/fmx037
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Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger &lt; 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion. Oxygen saturation, noninvasive total hemoglobin, noninvasive total oxygen content, perfusion index (PI), heart rate and systolic and diastolic blood pressures were assessed via the Radical-7 Pulse co-oximeter (Masimo, Irvine, CA, USA) with the Root monitor, initially and at 4 h. Results In all, 160 children were eligible for final analysis. The baseline hemoglobin level for the PRBC transfusion was 7.38 ± 0.98 g/dL for all patients. At the end of the PRBC transfusion, cardiac output decreased by 9.9% in Group 1 and by 24% in Group 2 (p  &lt; 0.001); PI increased by 10% in Group 1 and by 45% in Group 2 (p  &lt; 0.001). Lactate decreased by 9.8% in Group 1 and by 31.68% in Group 2 (p &lt; 0.001). Conclusion Restrictive blood transfusion strategy is better than liberal transfusion strategy with regard to the hemodynamic and laboratory values during the early period. PI also provides valuable information regarding the efficacy of PRBC transfusion in clinical practice.</description><identifier>ISSN: 0142-6338</identifier><identifier>EISSN: 1465-3664</identifier><identifier>DOI: 10.1093/tropej/fmx037</identifier><identifier>PMID: 28575484</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><ispartof>Journal of tropical pediatrics (1980), 2018-04, Vol.64 (2), p.118-125</ispartof><rights>The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c431t-709255d86868cba98aff41bead264eecc7e1f7150a64b02110e51722e2535b533</citedby><cites>FETCH-LOGICAL-c431t-709255d86868cba98aff41bead264eecc7e1f7150a64b02110e51722e2535b533</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28575484$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akyildiz, Basak</creatorcontrib><creatorcontrib>Ulgen Tekerek, Nazan</creatorcontrib><creatorcontrib>Pamukcu, Ozge</creatorcontrib><creatorcontrib>Dursun, Adem</creatorcontrib><creatorcontrib>Karakukcu, Musa</creatorcontrib><creatorcontrib>Narin, Nazmi</creatorcontrib><creatorcontrib>Yay, Mehmet</creatorcontrib><creatorcontrib>Elmali, Ferhan</creatorcontrib><title>Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit</title><title>Journal of tropical pediatrics (1980)</title><addtitle>J Trop Pediatr</addtitle><description>Abstract Background We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger &lt; 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion. Oxygen saturation, noninvasive total hemoglobin, noninvasive total oxygen content, perfusion index (PI), heart rate and systolic and diastolic blood pressures were assessed via the Radical-7 Pulse co-oximeter (Masimo, Irvine, CA, USA) with the Root monitor, initially and at 4 h. Results In all, 160 children were eligible for final analysis. The baseline hemoglobin level for the PRBC transfusion was 7.38 ± 0.98 g/dL for all patients. At the end of the PRBC transfusion, cardiac output decreased by 9.9% in Group 1 and by 24% in Group 2 (p  &lt; 0.001); PI increased by 10% in Group 1 and by 45% in Group 2 (p  &lt; 0.001). Lactate decreased by 9.8% in Group 1 and by 31.68% in Group 2 (p &lt; 0.001). Conclusion Restrictive blood transfusion strategy is better than liberal transfusion strategy with regard to the hemodynamic and laboratory values during the early period. 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Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger &lt; 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion. Oxygen saturation, noninvasive total hemoglobin, noninvasive total oxygen content, perfusion index (PI), heart rate and systolic and diastolic blood pressures were assessed via the Radical-7 Pulse co-oximeter (Masimo, Irvine, CA, USA) with the Root monitor, initially and at 4 h. Results In all, 160 children were eligible for final analysis. The baseline hemoglobin level for the PRBC transfusion was 7.38 ± 0.98 g/dL for all patients. At the end of the PRBC transfusion, cardiac output decreased by 9.9% in Group 1 and by 24% in Group 2 (p  &lt; 0.001); PI increased by 10% in Group 1 and by 45% in Group 2 (p  &lt; 0.001). Lactate decreased by 9.8% in Group 1 and by 31.68% in Group 2 (p &lt; 0.001). Conclusion Restrictive blood transfusion strategy is better than liberal transfusion strategy with regard to the hemodynamic and laboratory values during the early period. PI also provides valuable information regarding the efficacy of PRBC transfusion in clinical practice.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>28575484</pmid><doi>10.1093/tropej/fmx037</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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title Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit
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