Titre :

Pediatric plasma and platelet transfusions on extracorporeal membrane oxygenation: a subgroup analysis of two large international point-prevalence studies and the role of local guidelines

Auteur(s) :

Nellis, Marianne E. [Auteur]
Weill Cornell Medicine [Cornell University]
Saini, Arun [Auteur]
Spinella, Philip C. [Auteur]
Davis, Peter J. [Auteur]
Steiner, Marie E. [Auteur]
Tucci, Marisa [Auteur]
CHU Sainte Justine [Montréal]
Cushing, Melissa [Auteur]
Demaret, Pierre [Auteur]
Centre Hospitalier Universitaire de Liège [CHU-Liège]
Stanworth, Simon J. [Auteur]
Leteurtre, Stephane [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Karam, Oliver [Auteur]

Titre de la revue :

Pediatric Critical Care Medicine

Nom court de la revue :

Pediatr Crit Care Med

Numéro :

21

Pagination :

267-275

Éditeur :

Lippincott, Williams & Wilkins

Date de publication :

2019-10-22

ISSN :

1529-7535

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

OBJECTIVE: To describe the indications and thresholds for plasma and platelet transfusions for pediatric extracorporeal membrane oxygenation, to compare responses to these transfusions and to describe institutional protocols ...
Lire la suite >OBJECTIVE: To describe the indications and thresholds for plasma and platelet transfusions for pediatric extracorporeal membrane oxygenation, to compare responses to these transfusions and to describe institutional protocols directing their administration. METHODS: Subgroup analysis of two prospective, observational studies paired with survey of sites who enrolled subjects into this cohort. METHODS: Fifty-one PICUs in 13 countries. METHODS: Children (3 d to 16 yr old) were enrolled if they received a plasma or platelet transfusion while on extracorporeal membrane oxygenation during one of the predefined screening weeks. METHODS: None. RESULTS: Forty-eight children on extracorporeal membrane oxygenation received plasma transfusions and 90 received platelet transfusions. Sixty percent of plasma transfusions (29/48) and 79% of the platelet transfusions (71/90) were given for prophylaxis of bleeding. The median (interquartile range) international normalized ratio prior to transfusion, known in 75% of the patients (36/48), was 1.45 (1.20-1.85). The median (interquartile range) total platelet count prior to transfusion, known in all of the patients, was 70 × 10/L (52-90 × 10/L). The international normalized ratio and total platelet count values prior to transfusion did not vary based on bleeding versus nonbleeding indications. The median (interquartile range) reduction in international normalized ratio for mild coagulopathies (international normalized ratio ≤ 2.0) was 0.1 (0.4-0), median (interquartile range) increase in fibrinogen was 0.2 g/L (0.1-0.4 g/L) and median increase in total platelet count was 34 × 10/L (10-74 × 10/L). Through the course of their admission, children supported by extracorporeal membrane oxygenation received a total median (interquartile range) dose of 75 mL/kg (36-159 mL/kg) of plasma transfusions and 92 mL/kg (42-239 mL/kg) of platelet transfusions. Institutional protocols varied but provided guidance for platelet transfusions more commonly. CONCLUSIONS: Children supported by extracorporeal membrane oxygenation receive large volumes of plasma and platelet transfusions with some institutional guidance in the form of protocols, but significant variation in practice. Interventional studies are necessary to provide evidence to direct the transfusion of hemostatic products in children supported by extracorporeal membrane oxygenation.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T16:47:47Z
2024-04-09T08:32:14Z