Hemoglobin Threshold for Blood Transfusion in a Pediatric Intensive Care Unit

Chegondi, Madhuradhar; Sasaki, Jun; Raszynski, André; Totapally, Balagangadhar

doi:10.1159/000446253

Cited by 10 publications

(11 citation statements)

References 25 publications

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“…A previous study revealed the same result (OR 5.03; CI95%: 1.77–14.35) [ 10 ]. Bacteremia is the presence of pathogenic bacteria in circulation that has been found to have a significant relationship with mortality and morbidity in children [ 23 ]. Bacteremia has also been used to predict the presence of pneumonia caused by bacterial infection, which frequently had more severe clinical manifestations and complications [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country

Meliyanti

Rusmawatiningtyas

Makrufardi

et al. 2021

Heliyon

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Background: Pneumonia is still a major cause of death and incurs significant morbidity and mortality in developing countries. Thus, patients care does not only focus on treatment but also identifying factors that associated with the patient's outcome. Therefore we defined factors associated with mortality in pediatric pneumonia and assessed the outcome of pneumonia supported by mechanical ventilation in children. Methods: We performed cohort retrospective study by collecting data of pediatric pneumonia patients who admitted to Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, from 2014 to 2016. Chi square and multivariate logistic regression tests were used to analyze the variables: anemia, comorbidities, bacteremia, age between 1-6 months old, and underweight as associated factors for mortality. Results: One hundred and eleven children were included in this study. Those patients were diagnosed as community acquired pneumonia (79.3%), hospital acquired pneumonia (14.4%) and ventilator associated pneumonia (6.3%), with mortality rate 47.7%. Multivariate logistic regression analysis revealed that bacteremia, and underweight could be used as predictor factors of mortality for pediatric patients with pneumonia who were supported by mechanical ventilation with OR 2.5 (CI 95%: 1.03-6.1) and 2.4 (CI 95%: 1.1-5.7), respectively. Conclusion: Factors associated with mortality for pediatric patients with pneumonia who were supported by mechanical ventilation were bacteremia and underweight. It is necessary to compare our findings with other centers.

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Section: Discussionmentioning

confidence: 99%

Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country

Meliyanti

Rusmawatiningtyas

Makrufardi

et al. 2021

Heliyon

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“…We defined anemia based on laboratory results and the 2011 WHO recommendation for anemia diagnosis. Children were categorized as having anemia and non-anemia based on their age [ 9 ]. Cerebral edema was a condition of cerebral edema in patients that can be seen from the computerized tomography (CT) scan image and stated in the medical records [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

Factors associated with mortality in intracranial infection patients admitted to pediatric intensive care unit: A retrospective cohort study

Kholifia¹,

Rusmawatiningtyas²,

Makrufardi³

et al. 2021

Annals of Medicine and Surgery

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Background Intracranial infection is a major cause of emergency and death in children. To assist clinical decision-making in patient management, we conducted a study about factors associated with mortality. This study aimed to evaluate factors associated with mortality in pediatric patients with intracranial infection. Methods We performed a cohort retrospective study in our tertiary hospital to evaluate the outcomes of patients admitted to the pediatric intensive care unit (PICU) from 2014 to 2018. The Chi-square test was performed to determine the significance of the predictor, and p < 0.05 was considered to indicate a statistically significant result. We used multivariate logistic regression to determine relative risk (RR) with 95% confidence interval (CI). Results We recruited 112 patients who were admitted to the PICU of our tertiary hospital. A total of 38.4% were diagnosed with encephalitis, 9.8% meningitis and 51.8% meningoencephalitis. Of the 112 patients who met the inclusion criteria, 28 (25%) patients died in the PICU. The need of mechanical ventilation support variable had a statistically significant association with mortality (RR 22 . 76; 95% CI: 3 . 88–51.45). Conclusion Recognition of conditions that exacerbate intracranial infection in children needs to be done as early as possible. Moreover, the need of mechanical ventilation support in the PICU needs more attention.

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“…The stable group included the patients who did not meet the criteria mentioned earlier. In a previous study, hemoglobin threshold for blood transfusion requirements was studied using similar groups [ 6 ]. Each patient’s demographics variables, pre- and post-platelet transfusion clinical variables and mortality were recorded.…”

Section: Methodsmentioning

confidence: 99%

Platelet Transfusion Thresholds Among Children Admitted to a Pediatric Intensive Care Unit

Alsheikh

Chegondi

Totapally

2017

Cureus

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ObjectiveTo evaluate the threshold for platelet transfusion in children admitted to a pediatric intensive care unit (PICU). This is a retrospective chart review study, conducted at our tertiary level PICU and is related to critically ill pediatric patients who required platelet transfusion.MethodsWe retrieved the target patient population data from our blood bank database. The patients were subdivided into four subgroups: hematologic (hematologic malignancies, bone marrow suppression, hemolytic anemia, and sickle cell disease), surgical (post-surgical, trauma and acute bleeding), the unstable fraction of inspired oxygen (FiO2 > 0.6 and/or inotropic support), and the stable patients. Critically ill children between one month and 21 years of age were enrolled. We excluded patients who underwent extracorporeal membrane oxygenation (ECMO).ResultsA total of 197 transfusion episodes in 64 patients were analyzed. The distribution of transfusions episodes included hematologic 82% (n=161), surgical 7% (n=13), unstable 8% (n=16), stable 3% (n=7). The mean standard deviation (SD) of pre-transfusion platelet count (x1000) in all the patients and children in hematologic, surgical, unstable and stable groups were 29 (22), 29 (19), 47 (46), 28 (19), and 24 (14), respectively. The platelet count threshold for transfusion among the surgical group was higher compared to hematologic and unstable groups (p <0.001; analysis of variance (ANOVA) with multiple comparison tests). The mean platelet count during all episodes increased from 29 (22) to 71 (57) (p <0.05; paired t-test). The post-transfusion increase in platelet count was significantly higher among surgical and unstable patients compared to hematologic patients (p <0.001; ANOVA with multiple comparison tests).ConclusionThe most common indication for platelet transfusion in the pediatric intensive care unit (PICU) is the underlying hematologic condition. The platelet count threshold for transfusion varied with the clinical condition and is higher among the surgical patients. The rise of platelet count after transfusion was higher among the surgical and unstable patients.

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Hemoglobin Threshold for Blood Transfusion in a Pediatric Intensive Care Unit

Cited by 10 publications

References 25 publications

Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country

Factors associated with mortality in pediatric pneumonia patients supported with mechanical ventilation in developing country

Factors associated with mortality in intracranial infection patients admitted to pediatric intensive care unit: A retrospective cohort study

Platelet Transfusion Thresholds Among Children Admitted to a Pediatric Intensive Care Unit

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