Risk Factors for Red Blood Cell Transfusions in Children Undergoing Cardiac Catheterization

To identify risk factors associated with risk of red blood cell transfusions (RBCTs) following pediatric cardiac catheterizations. We performed a review of all pediatric cardiac catheterizations from 2012 to 2017. The primary endpoint was RBCT within 72 hours of pediatric cardiac catheterization. Pa...

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Veröffentlicht in:The Journal of pediatrics 2020-02, Vol.217, p.25-32.e4
Hauptverfasser: Ligon, R. Allen, Downey, Laura A., Gruenewald, David L., Bauser-Heaton, Holly D., Kim, Dennis W., Roman, Meredith F., Vincent, Robert N., Petit, Christopher J.
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container_end_page 32.e4
container_issue
container_start_page 25
container_title The Journal of pediatrics
container_volume 217
creator Ligon, R. Allen
Downey, Laura A.
Gruenewald, David L.
Bauser-Heaton, Holly D.
Kim, Dennis W.
Roman, Meredith F.
Vincent, Robert N.
Petit, Christopher J.
description To identify risk factors associated with risk of red blood cell transfusions (RBCTs) following pediatric cardiac catheterizations. We performed a review of all pediatric cardiac catheterizations from 2012 to 2017. The primary endpoint was RBCT within 72 hours of pediatric cardiac catheterization. Patient and procedural factors were reviewed. Generalized linear modelling was performed to describe interactions among relevant risk factors. In total, 831 RBCTs occurred within 72 hours of 6028 pediatric cardiac catheterizations (13.8%). Univariate analysis revealed that the prevalence of RBCT was highest among infants (37.6% incidence of RBCT) and among those with higher estimated blood loss as a percent of blood volume (P = .03). Among infants, multivariate analysis revealed that weight (OR 0.72; 95% CI 0.63-0.81), complex 2-ventricle (OR 3.14, 95% CI 2.18-4.57), and single ventricle status (OR 5.21, 95% CI 3.42-8.01) were associated with risk of RBCT. Inpatient infants from intensive care (OR 4.74; 95% CI 3.49-6.49) or stepdown units (OR 2.33; 95% CI 1.58-3.46) were at higher risk. Length of procedure (OR 2.57; 95% CI 2.03-3.26) and oxygen saturation (OR 0.98; 95% CI 0.97-0.99; P 
doi_str_mv 10.1016/j.jpeds.2019.10.033
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Allen ; Downey, Laura A. ; Gruenewald, David L. ; Bauser-Heaton, Holly D. ; Kim, Dennis W. ; Roman, Meredith F. ; Vincent, Robert N. ; Petit, Christopher J.</creator><creatorcontrib>Ligon, R. Allen ; Downey, Laura A. ; Gruenewald, David L. ; Bauser-Heaton, Holly D. ; Kim, Dennis W. ; Roman, Meredith F. ; Vincent, Robert N. ; Petit, Christopher J.</creatorcontrib><description>To identify risk factors associated with risk of red blood cell transfusions (RBCTs) following pediatric cardiac catheterizations. We performed a review of all pediatric cardiac catheterizations from 2012 to 2017. The primary endpoint was RBCT within 72 hours of pediatric cardiac catheterization. Patient and procedural factors were reviewed. Generalized linear modelling was performed to describe interactions among relevant risk factors. In total, 831 RBCTs occurred within 72 hours of 6028 pediatric cardiac catheterizations (13.8%). Univariate analysis revealed that the prevalence of RBCT was highest among infants (37.6% incidence of RBCT) and among those with higher estimated blood loss as a percent of blood volume (P = .03). Among infants, multivariate analysis revealed that weight (OR 0.72; 95% CI 0.63-0.81), complex 2-ventricle (OR 3.14, 95% CI 2.18-4.57), and single ventricle status (OR 5.21, 95% CI 3.42-8.01) were associated with risk of RBCT. Inpatient infants from intensive care (OR 4.74; 95% CI 3.49-6.49) or stepdown units (OR 2.33; 95% CI 1.58-3.46) were at higher risk. Length of procedure (OR 2.57; 95% CI 2.03-3.26) and oxygen saturation (OR 0.98; 95% CI 0.97-0.99; P &lt; .01) were also associated with RBCTs. Hospitalized infants with single ventricle or complex 2-ventricle anatomy are at highest risk of RBCT. Length of procedure, blood loss, and oxygen saturations are additional risk factors associated with RBCT. 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Allen</creatorcontrib><creatorcontrib>Downey, Laura A.</creatorcontrib><creatorcontrib>Gruenewald, David L.</creatorcontrib><creatorcontrib>Bauser-Heaton, Holly D.</creatorcontrib><creatorcontrib>Kim, Dennis W.</creatorcontrib><creatorcontrib>Roman, Meredith F.</creatorcontrib><creatorcontrib>Vincent, Robert N.</creatorcontrib><creatorcontrib>Petit, Christopher J.</creatorcontrib><title>Risk Factors for Red Blood Cell Transfusions in Children Undergoing Cardiac Catheterization</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To identify risk factors associated with risk of red blood cell transfusions (RBCTs) following pediatric cardiac catheterizations. We performed a review of all pediatric cardiac catheterizations from 2012 to 2017. The primary endpoint was RBCT within 72 hours of pediatric cardiac catheterization. Patient and procedural factors were reviewed. Generalized linear modelling was performed to describe interactions among relevant risk factors. In total, 831 RBCTs occurred within 72 hours of 6028 pediatric cardiac catheterizations (13.8%). Univariate analysis revealed that the prevalence of RBCT was highest among infants (37.6% incidence of RBCT) and among those with higher estimated blood loss as a percent of blood volume (P = .03). Among infants, multivariate analysis revealed that weight (OR 0.72; 95% CI 0.63-0.81), complex 2-ventricle (OR 3.14, 95% CI 2.18-4.57), and single ventricle status (OR 5.21, 95% CI 3.42-8.01) were associated with risk of RBCT. Inpatient infants from intensive care (OR 4.74; 95% CI 3.49-6.49) or stepdown units (OR 2.33; 95% CI 1.58-3.46) were at higher risk. Length of procedure (OR 2.57; 95% CI 2.03-3.26) and oxygen saturation (OR 0.98; 95% CI 0.97-0.99; P &lt; .01) were also associated with RBCTs. Hospitalized infants with single ventricle or complex 2-ventricle anatomy are at highest risk of RBCT. Length of procedure, blood loss, and oxygen saturations are additional risk factors associated with RBCT. 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Allen</creatorcontrib><creatorcontrib>Downey, Laura A.</creatorcontrib><creatorcontrib>Gruenewald, David L.</creatorcontrib><creatorcontrib>Bauser-Heaton, Holly D.</creatorcontrib><creatorcontrib>Kim, Dennis W.</creatorcontrib><creatorcontrib>Roman, Meredith F.</creatorcontrib><creatorcontrib>Vincent, Robert N.</creatorcontrib><creatorcontrib>Petit, Christopher J.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ligon, R. Allen</au><au>Downey, Laura A.</au><au>Gruenewald, David L.</au><au>Bauser-Heaton, Holly D.</au><au>Kim, Dennis W.</au><au>Roman, Meredith F.</au><au>Vincent, Robert N.</au><au>Petit, Christopher J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Red Blood Cell Transfusions in Children Undergoing Cardiac Catheterization</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2020-02</date><risdate>2020</risdate><volume>217</volume><spage>25</spage><epage>32.e4</epage><pages>25-32.e4</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To identify risk factors associated with risk of red blood cell transfusions (RBCTs) following pediatric cardiac catheterizations. We performed a review of all pediatric cardiac catheterizations from 2012 to 2017. The primary endpoint was RBCT within 72 hours of pediatric cardiac catheterization. Patient and procedural factors were reviewed. Generalized linear modelling was performed to describe interactions among relevant risk factors. In total, 831 RBCTs occurred within 72 hours of 6028 pediatric cardiac catheterizations (13.8%). Univariate analysis revealed that the prevalence of RBCT was highest among infants (37.6% incidence of RBCT) and among those with higher estimated blood loss as a percent of blood volume (P = .03). Among infants, multivariate analysis revealed that weight (OR 0.72; 95% CI 0.63-0.81), complex 2-ventricle (OR 3.14, 95% CI 2.18-4.57), and single ventricle status (OR 5.21, 95% CI 3.42-8.01) were associated with risk of RBCT. Inpatient infants from intensive care (OR 4.74; 95% CI 3.49-6.49) or stepdown units (OR 2.33; 95% CI 1.58-3.46) were at higher risk. Length of procedure (OR 2.57; 95% CI 2.03-3.26) and oxygen saturation (OR 0.98; 95% CI 0.97-0.99; P &lt; .01) were also associated with RBCTs. Hospitalized infants with single ventricle or complex 2-ventricle anatomy are at highest risk of RBCT. Length of procedure, blood loss, and oxygen saturations are additional risk factors associated with RBCT. Operators should consider these factors when planning pediatric cardiac catheterizations, particularly when exposure to RBCT is undesirable.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31732132</pmid><doi>10.1016/j.jpeds.2019.10.033</doi></addata></record>
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subjects cath lab
pediatric cardiology
title Risk Factors for Red Blood Cell Transfusions in Children Undergoing Cardiac Catheterization
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