Red blood cell concentrate transfusion strategies utilised at a tertiary-level paediatric intensive care unit: A descriptive study on impact and cost

Radebe, P B S; Jeena, Prakash

doi:10.7196/sajch.2018.v12i4.1517

Cited by 1 publication

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References 19 publications

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“…[30] The mortality rate (27.4%, p<0.001) of patients who were transfused blood products (blood, platelets or both) was similar to that found in a study in the same unit that reviewed blood transfusion strategies and found a mortality rate of 27.9% in patients who were managed according to a modified liberal transfusion strategy. [31] This was not in keeping with a previous SA study that showed that transfusion with blood products was not statistically significant for mortality. [32] Infection, particularly healthcare-associated infection, is commonplace in the PICU setting.…”

Section: Discussionmentioning

confidence: 60%

The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa

Clarence

Jeena²

2022

S Afr Med J

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Background. Paediatric intensive care, a valuable resource that improves the outcomes of critically ill children, is often scarce. Objective. To evaluate the need for paediatric intensive care beds and compare the outcomes of admitted and non-admitted deserving cases. Methods. A prospective evaluation of all bed requests, in terms of need for intensive care and outcomes of those admitted and not admitted to a paediatric intensive care unit (PICU), was performed between July 2017 and June 2018. Factors for refusal and for poor outcomes were evaluated. Results. Of the 811 bed requests, 32.6% (n=264, p<0.001) were denied access. Of the 231 deserving cases who were denied access, 85.7% (n=198) were due to unavailability of a PICU bed. Patients not admitted to PICU had a twofold increased risk of dying compared with those admitted (34.4% v. 15.5% respectively, p<0.001), even though the patient characteristics of both groups were similar (age, gender and nutritional status). In those admitted, risk factors for mortality were requiring transfusion of blood and platelets (56.0%, p<0.001), requiring two or more inotropes (52.5%, p<0.001), instability on admission (41.3%, p<0.001), prior cardiac arrest (32.0%, p=0.021), severe acute malnutrition (26.9%, p=0.043), fungal infection (22.2%, p=0.004) and emergency admission (18.0%, p<0.001). In those not admitted, prior cardiac arrest (100%, p<0.001) and emergency referral (42.3%, p<0.001) were associated with adverse outcomes. Conclusion. The need for PICU beds exceeds availability, with a consequent twofold increase in mortality among cases not admitted to PICU. Paediatric critical care services have increased at appropriate sites of need following completion of this study.

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Section: Discussionmentioning

confidence: 60%

The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa

Clarence

Jeena²

2022

S Afr Med J

View full text Add to dashboard Cite

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Red blood cell concentrate transfusion strategies utilised at a tertiary-level paediatric intensive care unit: A descriptive study on impact and cost

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 1 publication

References 19 publications

The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa

The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa

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