title: A survey of blood transfusion practice in French-speaking pediatric anesthesiologists.
abstract: BACKGROUND
  There are so far no existing consensus guidelines regarding red blood cell transfusion during pediatric surgery, and there is a little information regarding red blood cell transfusion policy among pediatric anesthesiologists.
  
  
  OBJECTIVE
  To determine the transfusion threshold and the volumes of packed red blood cell (PRBC) transfusion among French-speaking pediatric anesthesiologists.
  
  
  METHODS
  A questionnaire of case scenarios was sent to active members of the French Language Society of Pediatrics Anesthesiologists (ADARPEF).
  
  
  RESULTS
  Of the 324 active members of the ADARPEF, 175 (54%) completed the questionnaire. The threshold for blood transfusion varied from 6 to 12 g·dl(-1) depending on the scenario. The hemoglobin threshold for blood transfusion and the volume of blood transfused vary among ADARPEF physicians, for the same class of patients. The median [95% CI] hemoglobin threshold for starting blood transfusion was 7.9 [6.9-8.9], 7.3 [6.4-8.2], and 8.1 [7.0-9.2] g·dl(-1) in the pre-, intra-, and postoperative phase, respectively. The median [95% CI] PRBC volume transfused was 11.7 [6.6-16.8] ml·kg(-1), and the median hemoglobin target was 11.3 [9.8-12.8] g·dl(-1). Physicians ranked age (79%), clinical tolerance of anemia (99%), underlying medical conditions (95%), hemodynamic instability (89%), hemostasis disorder (86%), and sepsis (79%) as the most significant factors affecting their transfusion decisions. Most pediatric anesthesiologists (89%) measure the hemoglobin level before PRBC transfusion.
  
  
  CONCLUSIONS
  This survey identifies significant differences in transfusion practice patterns among pediatric anesthesiologists with a median transfusion threshold of 7.6 [6.6-8.6] g·dl(-1) and a median PRBC volume transfusion of 11.7 [16.8-6.6] ml·kg(-1).
authors.affiliation: Department of Anesthesiology and Critical Care, Hôpital Necker-Enfants Malades, AP-HP, University Paris Descartes, Paris Cedex 15, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Jouffroy
authors.forename: Thomas
authors.initials: T
authors.lastname: Baugnon
authors.forename: Pierre
authors.initials: P
authors.lastname: Carli
authors.forename: Gilles
authors.initials: G
authors.lastname: Orliaguet
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000628:therapy; D000776:Anesthesiology / Q000592:standards / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000592:standards / Q000706:statistics & numerical data*; D002648:Child; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006439:Hemodynamics / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007432:Intraoperative Period; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins