Survey on transfusion practices of pediatric intensivists.
OBJECTIVE
To describe the red blood cell transfusion practices of pediatric intensivists.


METHODS
Cross-sectional self-administered survey.


METHODS
Pediatric intensive care units.


METHODS
Academic pediatric intensivists.


METHODS
None.


RESULTS
Scenario-based survey among English- or French-speaking intensivists from Canada, France, Belgium, or Switzerland, working in tertiary-care pediatric intensive care units. Respondents were asked to report their decisions regarding transfusion practice with respect to four scenarios: cases of bronchiolitis, septic shock, trauma, and the postoperative care of a patient with Fallot's tetrad. The response rate was 71% (163 of 230). The overall baseline hemoglobin transfusion threshold that would have prompted intensivists to transfuse a patient ranged from 7 to 13 g/dL (70-130 g/L) within almost all scenarios. There was a significant difference between scenarios of the average baseline hemoglobin transfusion thresholds (p < .0001). A low Pao2, a high blood lactate concentration, a high Pediatric Risk of Mortality score, active gastric bleeding, emergency surgery, and age (2 wks) were important determinants of red blood cell transfusion, whereas none of the respondents' personal characteristics were. The average volume of packed red blood cells transfused in the four scenarios did not differ significantly.


CONCLUSIONS
This survey documented a significant variation in transfusion practice patterns among pediatric critical care practitioners with respect to the threshold hemoglobin concentration for red blood cell transfusion. The volume of packed red blood cells given was not adjusted to the hemoglobin concentration.
Laverdière
Caroline
C
Hematology Division, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Québec, Canada.
Gauvin
France
F
Hébert
Paul C
PC
Infante-Rivard
Claire
C
Hume
Heather
H
Toledano
Baruch J
BJ
Guertin
Marie-Claude
MC
Lacroix
Jacques
J