Transfusion of Blood and Components in Critically Ill Children

Abstract

The physicians prescribing transfusions must have a thorough understanding of the various blood products, their indications and contraindications, and requirements for modification of the blood products to prevent probable adverse effects. Decision to give an RBC transfusion should not be based solely on Hb concentration, it should take in account high severity of illness; active bleeding; emergency surgery; etc. Using restrictive transfusion strategy of transfusion RBCs can decrease transfusion requirements without increasing adverse outcomes. In most circumstances, platelets should be maintained greater than 10×10(9)/L. Platelet counts greater than 20×10(9)/L are indicated for invasive procedures and greater than 50×10(9)/L for major surgeries or invasive procedures with risk of bleeding. Whenever possible, ABO-compatible platelets should be administered. Fresh frozen plasma should be transfused in multiple coagulation factor deficiencies, DIC with bleeding, replacement of rare single congenital factor deficiencies when specific concentrates are not available (e.g., protein C or factor II, V, X, XI, or XIII deficiency). During transfusion child should be monitored carefully.

“Parenteral” Diarrhea Associated With Pediatric Urinary Tract Infections

“…Although several studies looked at the spectrum of coinfections reported with UTIs, none investigated exclusively for diarrhea 12,13 . Conversely, there are a number of cohort and case control studies of children presenting with diarrhea that specifically studied the incidence of associated culture-proven UTIs 14–23 . In addition, 2 studies were discovered during our review of the literature that included reports of diarrhea in children diagnosed with UTIs.…”