title: Red blood cell transfusion: decision making in pediatric intensive care units.
abstract: The results of the Transfusion Requirements in Pediatric Intensive Care Unit study suggest that a red blood cell transfusion is not required in stable or stabilized pediatric intensive care unit children as long as their hemoglobin level is >7 g/dL. Subgroup analyses suggest that this recommendation is also adequate for stable critically ill children with a high severity of illness, respiratory dysfunction, acute lung injury, sepsis, neurological dysfunction, severe head trauma, or severe trauma, and during the postoperative period, for noncyanotic patients older than 28 days. A small randomized clinical trial suggests that a hemoglobin level of 9 g/dL is safe in the postoperative care of children with single-ventricle physiology undergoing cavopulmonary connection. Although there is consensus that blood is clearly indicated for the treatment of hemorrhagic shock, the clinical determinants that should prompt pediatric intensivists to prescribe a red blood cell transfusion to unstable PICU children are not well characterized.
authors: Division of Pediatric Critical Care, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montréal, Quebec, Canada. jacques_lacroix@ssss.gouv.qc.ca
authors: Jacques
authors: J
authors: Lacroix
authors: Pierre
authors: P
authors: Demaret
authors: Marisa
authors: M
authors: Tucci
mesh_terms: D002648:Child; D016638:Critical Illness / Q000628:therapy*; D003657:Decision Making; D004909:Erythrocyte Indices; D017707:Erythrocyte Transfusion / Q000592:standards*; D006454:Hemoglobins; D006801:Humans; D015278:Intensive Care Units, Pediatric; D010372:Pediatrics / Q000379:methods*; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins