Analysis of pediatric adverse reactions to transfusions

Vossoughi, Sarah; Perez, Gabriela; Whitaker, Barbee I.; Fung, Mark; Stotler, Brie A.

doi:10.1111/trf.14359

Cited by 72 publications

(82 citation statements)

References 14 publications

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“…Current expert consensus guidelines recommend taking into consideration the individual patient's clinical status along with an optimum hemoglobin target. In general, recommendations for pediatric patients (excluding neonates) suggests that a hemoglobin threshold transfusion target of 7 g/dL (70 g/L) is appropriate in a hemodynamically stable well compensated patient and that, , in general, given a hemoglobin concentration of >9 g/dL (90 g/L), red blood transfusion is unnecessary and inappropriate . Neonates, are physiologically quite distinct from infants and young children and require a specific and different set of hemoglobin thresholds and transfusion guidelines .…”

Section: Standard 13 Guidence Patient Blood Management For Pediatricmentioning

confidence: 99%

“…Twelve percent of all pediatric cardiac arrests have been attributed to hypovolemia associated with blood loss. Although improvements in hemovigilance have significantly reduced the risk of transfusion‐related infections, reports of pediatric non‐infectious transfusion‐associated complications have increased . Transfusion‐related acute lung injury, transfusion‐related acute circulatory overload, and hemolytic transfusion reactions are the main culprits with mortality rates as high as 15%‐30%.…”

Section: Introductionmentioning

confidence: 99%

“…Although improvements in hemovigilance have significantly reduced the risk of transfusion-related infections, reports of pediatric non-infectious transfusion-associated complications have increased. 18,28,32,33 Transfusion-related acute lung injury, transfusion-related acute circulatory overload, and hemolytic transfusion reactions are the main culprits with mortality rates as high as 15%-30%. Allogeneic red blood cell transfusion is associated with an increased incidence of 30-day mortality and complications in children.…”

mentioning

confidence: 99%

“…In general, recommendations for pediatric patients (excluding neonates) suggests that a hemoglobin threshold transfusion target of 7 g/dL (70 g/L) is appropriate in a hemodynamically stable well compensated patient and that, in general, given a hemoglobin concentration of >9 g/dL (90 g/L), red blood transfusion is unnecessary and inappropriate. 5,19,25,26,31,32 Neonates, are physiologically quite distinct from infants and young children and require a specific and different set of hemoglobin thresholds and transfusion guidelines. 8,18,20,33 This is confounded by the fact that they have varying hemoglobin levels and types, and potentially a limited ability to tolerate physiologic stress, and a weak immune response.…”

mentioning

confidence: 99%

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Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

Goobie¹,

Gallagher²,

Gross

et al. 2019

Pediatric Anesthesia

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Summary Patient Blood Management is the timely application of evidence‐based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss to improve patient outcomes. Conceptually similar to a “bundle” strategy, it is designed to improve clinical care using comprehensive evidence‐based treatment strategies to manage patients with potential or ongoing critical bleeding, bleeding diathesis, critical anemia, and/ or a coagulopathy. Patient Blood Management includes multimodal strategies to screen, diagnose and properly treat anemia, coagulopathies and minimize bleeding, using goal‐directed therapy and leverages a patient's physiologic ability to adapt to anemia while definitive treatment is undertaken. Allogeneic blood component transfusion is one traditional therapeutic modality out of many for managing blood loss and anemia and, while it may be the best choice in certain situations, other effective and more appropriate options are available and should be used in conjunction or alone. Therefore, comprehensive Patient Blood Management is the new standard of care to prevent and manage anemia and optimize hemostasis and has been recommended by the World Health Organization, the American Society of Anesthesiologists, the European Society of Anaesthesiology and the Australian National Blood Authority. While there is a plethora of expert consensus and good practice guidelines published for blood component transfusion from multiple professional organizations and societies, there remains a need for more comprehensive and broader standards of patient medical management to proactively reduce the risk of exposure to allogeneic transfusions. In 2010, the Society for Advancement of Blood Management published the first comprehensive standards to address the administrative and clinical components of an effective, patient‐centered Patient Blood Management program. Recognizing the need to reduce inappropriate transfusions, some professional organizations have placed their emphasis on transfusion guidelines. In contrast, the focus of the Society for Advancement of Blood Management Standard is on the centrality of the patient and the full spectrum of therapeutic strategies needed to improve clinical outcomes in patients at risk for blood loss or anemia, thereby reducing avoidable transfusions as well. The Standards are meant not to replace, but to complement transfusion guidelines by more completely addressing the need for a multi‐modal clinical approach with the goal to improve patient outcomes. Compared to adult programs, Pediatric Patient Blood Management programs are currently not commonly accepted as standard of care for pediatric patients. This is partly due to the fact that, until recently, there was a paucity of robust evidence‐based literature and expert consensus guidelines on pediatric PBM. Managing pediatric bleeding and blood product transfusion presents a unique set of challenges. The main goal of transfusion is to correct or avoid imminent inadequate oxygen c...

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Section: Standard 13 Guidence Patient Blood Management For Pediatricmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version)

Goobie¹,

Gallagher²,

Gross

et al. 2019

Pediatric Anesthesia

View full text Add to dashboard Cite

show abstract

“…Again, we and others have observed no difference in the rate of adverse transfusion events or in PLT utilization for patients receiving PR PLTs compared to conventional PLTs in these groups. [33][34][35][36][37][38][39]44 Although the small sample size precludes generalization, no cases of TA-GVHD were identified among any of our autologous and allogeneic hematopoietic stem cell transplant patients who received PR PLT transfusions that were not irradiated. 39 Similar findings regarding the lack of reports of TA-GVHD in comparable recipients of nonirradiated PR PLTs have been published.…”

Section: Ongoing Quality Monitoringmentioning

confidence: 99%