Transfusão de eritrócitos em crianças internadas em unidade de terapia intensiva pediátrica

Marvulo, Nelise Luciano; Bonatto, Rossano César; Carpi, Mário Ferreira; Ricchetti, Sandra M. Q.; Moraes, Marcela Aparecida de; Fioretto, José Roberto

doi:10.1590/s0103-507x2006000400012

Cited by 4 publications

(4 citation statements)

References 6 publications

(9 reference statements)

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“…More than half of the transfusions occurred in children less than 1 year of age, data similar to those observed in a publication that included a similar population. 28 In the trigger analysis, there was inadequacy mainly in transfusions based only on Hb values, without considering the clinical picture, with pre transfusion Hb ≥ 10 g/dL, performed in the infirmary ward and in patients with respiratory disease without respiratory failure or mechanical ventilation. The largest study ever published with a pediatric population has shown that the prescription of red blood cells based on current recommendations decreases the number of transfused RBCs by 44%.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Faria

Victorino²,

Souza

et al. 2018

Rev. Assoc. Med. Bras.

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Objective: To verify the adequacy of red blood cell (RBC) prescription to pediatric patients in different sectors of a pediatric hospital. Method: A retrospective study was conducted including 837/990 RBC transfusion requisition forms for children and adolescents (0 to 13 years old) filed in between January 2007 and April 2015 by the pediatricians of the emergency room (ER), infirmary ward and intensive care unit (pICU). Transfusion requisition forms belonging to patients with chronic anemia or acute hemorrhage, as well as incompletes requisition forms, were excluded. Results: Trigger, prescribed volume and subtype of RBC concentrates were adequate in 532 (65.3%), 460 (58.8%) and 805 (96.2%) of the transfusions, respectively. When the clinical picture was considered, prescription adequacy was higher compared to the use of the hemoglobin level alone (70.9% vs. 41%). The pICU had the highest correct trigger percentage (343 [71.6%]; p<0.001) while the ER showed more often adequate prescribed volumes (119 [66.1%]; p=0.020). The most common inadequacy regarding volume was that of prescriptions above the recommendation > 15 mL/kg found in 309 cases (36.9%). Thirty-two (32) RBC subtypes were requested and none were consistent with current recommendations. Conclusion:The results obtained in our study showed that RBC transfusion occurred more appropriately when the clinical picture was taken into account at request. There was a tendency to prescribe higher volumes and RBC subtypes without the justification of current protocols. Hemotherapic teachings at undergraduate level and medical residency must be improved.

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Section: Discussionmentioning

confidence: 99%

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Faria

Victorino²,

Souza

et al. 2018

Rev. Assoc. Med. Bras.

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show abstract

“…Another national survey mentioned that pre-transfusion hemoglobin values were not recorded; thus, the development of a transfusion protocol is required (25) . In our study, in addition to the adequate and inadequate categories, we included the inconclusive category.…”

Section: Discussionmentioning

confidence: 99%

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

Souza¹,

Silva²,

Costa³

2013

Revista Brasileira De Hematologia E Hemoterapia

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BackgroundBlood products and derivatives are indispensable resources in medical therapies. However, it is important to note that the number of donations is far from ideal. Despite constant campaign efforts, a deficit of 1 million units is expected by 2030. ObjectivesTo determine the adequacy of the indications for red blood cell transfusion in an emergency hospital in Alagoas.MethodsThis was a cross-sectional observational study conducted at the Alagoas Blood Center. Of a total of 2936 red blood cell transfusion requests in 2009, 334 were randomized and compared with transfusion parameters described in the literature (primary variable). After analysis, the transfusion requests were categorized as adequate, inadequate or inconclusive. This last group included all red blood cell transfusion requests with insufficient clinical information, rendering their classification as adequate or inadequate impossible. The secondary variable involved the reasons for red blood cell transfusion. A 95% confidence interval was used in the statistical analysis. ResultsForty-seven (14.07%) requests were adequate and 30 (8.98%) were inadequate. Most of the requests were classified as inconclusive (76.94%). The main indications for transfusion were upper gastrointestinal bleeding (26.95%), anemia (46.71%), hypovolemia/hypovolemic shock (10.78%) and sepsis/septic shock (3.29%). ConclusionIt was not possible to reach a conclusion on the adequacy of the indication for transfusion in most of the cases. Therefore, it is important to adopt a transfusion protocol, rigorously analyze blood bank requests, to provide awareness campaigns on the rational use of blood and to implement strategies to use blood products more effectively.

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“…In Brazil, Sekine et al concluded that 68% of the RBC requests submitted within a public hospital were in accordance with the criteria proposed by the hospital (15) . Another national survey mentioned that pre-transfusion hemoglobin values were not recorded; thus, the development of a transfusion protocol is required (25) . In our study, in addition to the adequate and inadequate categories, we included the inconclusive category.…”

Section: Resultsmentioning

confidence: 99%

“…Their indiscriminate use carries the risk of increased susceptibility to hospital-acquired infections, transmission of infectious diseases, TRALI, increased expenditure and mortality in critically ill patients (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) . Several research groups have studied the unnecessary use of blood products (15,16,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . In a study at the Melbourne Royal Hospital, Metz the importance of the blood bank staff reviewing the indications for blood transfusions as well as the formation of a transfusion committee (29,30) .…”

Section: Discussionmentioning

confidence: 99%

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

Souza¹,

Silva²,

Costa³

2013

Revista Brasileira De Hematologia E Hemoterapia

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Transfusão de eritrócitos em crianças internadas em unidade de terapia intensiva pediátrica

Cited by 4 publications

References 6 publications

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Assessment of the prescription of red blood cell concentrates in the pediatric age group

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

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