title: Survey on transfusion practices of pediatric intensivists.
abstract: 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.
authors.affiliation: Hematology Division, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Québec, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Laverdière
authors.forename: France
authors.initials: F
authors.lastname: Gauvin
authors.forename: Paul C
authors.initials: PC
authors.lastname: Hébert
authors.forename: Claire
authors.initials: C
authors.lastname: Infante-Rivard
authors.forename: Heather
authors.initials: H
authors.lastname: Hume
authors.forename: Baruch J
authors.initials: BJ
authors.lastname: Toledano
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Guertin
authors.forename: Jacques
authors.initials: J
authors.lastname: Lacroix