Pediatric red blood cell transfusions increase resource use.
OBJECTIVE
To test the hypothesis that red blood cell transfusions are associated with increased resource utilization and mortality in critically ill children.


METHODS
Five pediatric intensive care units (PICUs) participated in a retrospective, cohort analysis (1996-1999). Children with a hemoglobin value <or=9 g/dL during their PICU stay were enrolled. Data consisted of descriptive information, hemoglobin values, use of blood products, PICU resource use, and hospital mortality rate.


RESULTS
Among 240 children, 131 were transfused and 109 were not transfused. After controlling for the effects of other variables, transfusion was associated with an increase in days of oxygen use (4.48 +/- 1.37 days), days of mechanical ventilation (4.05 +/- 1.10 days), days of vasoactive agent infusions (1.27 +/- 0.44 days), and an increase of PICU and hospital lengths of stay (4.44 +/- 1.32, and 7.75 +/- 2.36 days, respectively).


CONCLUSIONS
Red blood cell transfusions are associated with an increase in resource utilization in critically ill children. The decision to transfuse patients should incorporate this potential morbidity.
Goodman
Allyson M
AM
Divisions of Critical Care Medicine, Children's Research Institute, George Washington University School of Medicine, Washington, DC 20010, USA.
Pollack
Murray M
MM
Patel
Kantilal M
KM
Luban
Naomi L C
NL
D000740:Anemia / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003691:Delaware / Q000453:epidemiology; D004219:District of Columbia / Q000453:epidemiology; D017707:Erythrocyte Transfusion / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data*; D006302:Health Services Research; D006454:Hemoglobins / Q000032:analysis; D017052:Hospital Mortality; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008396:Maryland / Q000453:epidemiology; D009515:New Jersey / Q000453:epidemiology; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D018579:Patient Selection; D010372:Pediatrics / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index
D006454:Hemoglobins