Guidelines for assessing appropriateness of pediatric transfusion

Roseff, Susan D.; Luban, Naomi L.C.; Manno, Catherine S.

doi:10.1046/j.1537-2995.2002.00208.x

Cited by 210 publications

(141 citation statements)

References 165 publications

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“…Other studies have shown conflicting reports regarding improvement of short term effects of apnoea, tachycardia and bradycardia following transfusion 1,11,12 . In current practice various clinical, laboratory and bedside biomarkers are regularly used to identify the need for transfusion in preterm infants 13 .…”

Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants

Banerjee

Leung

Aladangady

2016

Early Human Development

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word count: 400 words (maximum 400) Manuscript body word count: 4057 words (maximum 6000) 2 | P a g e AbstractPreterm infants frequently receive blood transfusion during their stay in neonatal unit, and its impact on organ perfusion and oxygenation is not clear. The aim of the study was to measure the effect of blood transfusion on cerebral blood flow and oxygenation in preterm infants in relation to chronological age.Fifty nine infants were studied: group 1=20, group 2=21 and group 3=18 infants with median age (range) at transfusion of 5 (1-7), 14 (8-27) and 45 (29-68) days respectively. Gestational age and birth weight of infants between groups were similar. Pre-transfusion vital parameters were similar between the groups except the heart rate was significantly higher in group 1 compared to group 3 (p=0.02). The mean BP increased significantly in all three groups and there were no significant changes in other vital parameters following transfusion.There was no change in pre and post transfusion pCO2 and pH in blood gas. The mean pretransfusion Anterior Cerebral artery (ACA) time averaged mean velocity (TAMV) increased significantly with chronological age (p<0.001), and ACA Peak Systolic Velocity (PSV) also increased with chronological age of infants but this was not significant. Pre-transfusion ACA TAMV and PSV decreased significantly (p≤0.04), and there was no change in ACA Resistance Index (RI) and Pulsatility Index (PI) following transfusion in infants of all 3 groups. The pre-transfusion mean Superior Vena Cava (SVC) flow decreased significantly in Group 1 (p=0.03) and Group 3 (p<0.001) following transfusion, but the change was not significant in the Group 2 infants (p=0.16). The mean pre-transfusion cerebral tissue oxygenation index (cTOI) levels were significantly lower in group 3 compared to group 1 (p=0.02). The cerebral tissue haemoglobin level cTHI (p<0.001) and cTOI (p<0.05) increased significantly post-transfusion in all the three groups. The percentage increase in post-transfusion cTOI from baseline was 5%, 11% and 12% in group 1, group 2 and group 3 3 | P a g e infants respectively. On comparing infants with PDA (n=14) to gestational and chronological age matched controls (n=14), there was no significant difference in these measurements.Baseline cTOI decrease and ACA TAMV increase with increasing chronological age. Blood transfusion increased cTOI and cTHI, and decreased ACA TAMV in all age group of infants but the proportion of response is different. PDA had no impact on the baseline cerebral oximetry and blood flow as well as changes following transfusion. Future transfusion trials should take into account the impact of postnatal age on cerebral oximetry and blood flow.

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Section: Introductionmentioning

confidence: 99%

Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants

Banerjee

Leung

Aladangady

2016

Early Human Development

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“…34 These consensus guidelines list only a few clear-cut indications for plasma transfusion, including the treatment of thrombotic thrombocytopenic purpura, 12,19,41 emergency reversal of vitamin K antagonists (prothrombin complex concentrate containing all VKD factors is the first choice), and treatment of bleeding due to multiple factor deficiencies as seen with trauma, disseminated intravascular coagulation, severe chronic liver disease, and so forth.…”

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confidence: 99%

Coagulation factor levels in neurosurgical patients with mild prolongation of prothrombin time: effect on plasma transfusion therapy

Matevosyan¹,

Madden²,

Barnett³

et al. 2011

JNS

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H emostasis is a complex interaction among 1) the fluid phase of procoagulants that generate thrombin, 2) the natural anticoagulants that regulate thrombin, 3) the fibrinolytic system that controls the size of thrombus and maintains vascular patency, and 4) the cellular phase that includes platelets and endothelium. To date, no single global test exists to assess these 4 components of hemostasis. The in vitro coagulation tests, the PT and PTT, were developed to identify the cause of bleeding in a symptomatic bleeding patient; they have never been shown to assess the risk of bleeding in a nonbleeding patient. 16,20,35 Because different sensitivities of tissue thromboplastin reagents account for the variability of PT, the INR was introduced to monitor warfarin therapy. The INR is a calculated value derived by the following formula: (patient PT/mean normal PT) ISI , where ISI is a value assigned to the PT reagent when compared with a WHO reference standard with an ISI of 1.0. 31,43,44 The INR was standardized on plasmas from patients on chronic warfarin therapy that affects only VKD factors II, VII, IX, and X. Use of the INR is therefore inappropriate in other medical conditions in which clotting factors other than VKD factors are affected.10 However, the INR is often (mis)used in clinical practice to assess hemostasis in patients not receiving warfarin therapy; thus, patients with mildly elevated INRs are reflexively transfused with FFP, usually perioperatively.In the past, less-sensitive thromboplastin reagents (ISI > 2.0) caused a prolonged PT only when factor VII Coagulation factor levels in neurosurgical patients with mild prolongation of prothrombin time: effect on plasma transfusion therapy Object. Neurosurgical patients often have mildly prolonged prothrombin time (PT) or international normalized ratio (INR). In the absence of liver disease this mild prolongation appears to be due to the use of very sensitive PT reagents. Therefore, the authors performed relevant coagulation factor assays to assess coagulopathy in such patients. They also compared plasma transfusion practices in their hospital before and after the study.Methods. The authors tested 30 plasma specimens from 25 patients with an INR of 1.3-1.7 for coagulation factors II, VII, and VIII. They also evaluated plasma orders during the 5-month study period and compared them with similar poststudy periods following changes in plasma transfusion guidelines based on the study results.Results. At the time of plasma orders the median INR was 1.35 (range 1.3-1.7, normal reference range 0.9-1.2) with a corresponding median PT of 13.6 seconds (range 12.8-17.6 seconds). All partial thromboplastin times were normal (median 29.0 seconds, range 19.3-33.7 seconds). The median factor VII level was 57% (range 25%-124%), whereas the hemostatic levels recommended for major surgery are 15%-25%. Factors II and VIII levels were also within the hemostatic range (median 72% and 118%, respectively). Based on these scientific data, plasma transfusion guidelines were mod...

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“…Transfusi PRC juga dapat diberikan pada pasien pasca operasi dengan tanda dan gejala anemia dan kadar Hb <10,0 g/dL, serta pasien yang menderita penyakit kardiopulmonal berat dengan kadar Hb <12,0 g/dL. [5][6][7] Dosis yang digunakan untuk transfusi PRC pada anak adalah 10-15 mL/kgBB/hari apabila Hb >6,0 g/dL, sedangkan pada Hb <5,0 g/dL, transfusi PRC dapat dilakukan dengan dosis 5 mL/kgBB dalam 1 jam pertama. Pada keadaan darurat sisa darah yang masih ada pada kantong dihabiskan dalam 2-3 jam selanjutnya, asalkan total darah yang diberikan tidak melebihi 10-15 mL/kgBB/hari.…”

Section: Transfusi Sel Darah Merah Pekat/packed Red Cells (Prc)unclassified

Transfusi Rasional pada Anak

Wahidiyat

Adnani

2017

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AbstrakTransfusi darah adalah rangkaian proses memindahkan darah atau komponen darah dari donor kepada resipien. Pada kasus-kasus tertentu, transfusi darah dapat sangat bermanfaat atau bahkan menyelamatkan nyawa pasien. Transfusi darah pada praktik klinik dapat menggunakan berbagai jenis komponen, baik darah lengkap (whole blood), sel darah merah pekat (packed red cells/PRC), sel darah merah yang dicuci (washed erythrocytes/WE), trombosit, plasma segar beku (fresh frozen plasma/FFP), kriopresipitat, dan sebagainya sesuai indikasi. Untuk memastikan bahwa transfusi darah dapat memberikan manfaat yang optimal bagi resipien, penyimpanan, penanganan, dan uji kompatibilitas untuk produk darah harus dilaksanakan dengan baik sesuai pedoman. Tujuan transfusi darah secara umum untuk mengembalikan serta mempertahankan volume normal peredaran darah, mengganti kekurangan komponen selular darah, meningkatkan oksigenasi jaringan, serta memperbaiki fungsi homeostasis pada tubuh. Sari Pediatri 2016;18(4):325-31Kata kunci: transfusi darah, homeostatis, donor Rational Blood Transfusion in ChildrenPustika Amalia Wahidiyat, Nitish Basant Adnani AbstractBlood transfusion refers to a process of transfer of blood or blood components from a donor to a recipient. In certain cases, blood transfusion may be highly beneficial or even save the life of a patient. The implementation of blood transfusion in clinical practice may involve different types of blood components, including whole blood, packed red cells (PRC), washed erythrocytes (WE), thrombocytes, fresh frozen plasma (FFP), cryoprecipitates, and so on, depending on the indication for transfusion. To ensure that blood transfusion leads to maximum benefits for the patient, the storage, handling, and compatibility testing for blood products should be conducted in accordance to the established guidelines. The purpose of blood transfusion in general is to maintain the normal volume of blood flow, replace the lack of a particular cellular component in the blood, improve tissue oxygenation, and maintain homeostasis of the body. Sari Pediatri 2016;18(4):325-31

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Guidelines for assessing appropriateness of pediatric transfusion

Cited by 210 publications

References 165 publications

Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants

Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants

Coagulation factor levels in neurosurgical patients with mild prolongation of prothrombin time: effect on plasma transfusion therapy

Transfusi Rasional pada Anak

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