Titre :

Recommendations on rbc transfusions in critically ill children with acute respiratory failure from the pediatric critical care transfusion and anemia expertise initiative

Auteur(s) :

Demaret, Pierre [Auteur]
Emeriaud, Guillaume [Auteur]
Hassan, Nabil E. [Auteur]
Kneyber, Martin C. J. [Auteur]
Valentine, Stacey L. [Auteur]
Bateman, Scot T. [Auteur]
Tucci, Marisa [Auteur]

Titre de la revue :

Pediatric critical care medicine . a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Nom court de la revue :

Pediatr Crit Care Med

Numéro :

19

Pagination :

S114-S120

Date de publication :

2018-09-01

ISSN :

1529-7535

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

To present the recommendations and supporting literature for RBC transfusions in critically ill children with bleeding developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Consensus conference ...
Lire la suite >To present the recommendations and supporting literature for RBC transfusions in critically ill children with bleeding developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Consensus conference series of international, multidisciplinary experts in RBC transfusion management of critically ill children. The panel of 38 experts developed evidence-based and, when evidence was lacking, expert-based clinical recommendations as well as research priorities for RBC transfusions in critically ill children. The respiratory subgroup included six experts. Electronic searches were conducted using PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017. Agreement was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. Transfusion and Anemia Expertise Initiative experts developed seven recommendations focused on children with acute respiratory failure. All recommendations reached agreement (> 80%). Transfusion of RBCs in children with respiratory failure with an hemoglobin level less than 5 g/dL was strongly recommended. It was strongly recommended that RBCs not be systematically administered to children with respiratory failure who are hemodynamically stable and who have a hemoglobin level greater than or equal to 7 g/dL. Experts could not make a recommendation for children with hemodynamic instability, with severe hypoxemia and/or with an hemoglobin level between 5 and 7 g/dL. Specific RBC transfusion strategies using physiologic-based metrics and biomarkers could not be elaborated. The Transfusion and Anemia Expertise Initiative Consensus Conference developed specific recommendations regarding RBC transfusion management in critically ill children with respiratory failure, as well as recommendations to guide future research. Clinical recommendations emphasize relevant hemoglobin thresholds. Research recommendations emphasize the need to identify appropriate physiologic thresholds, suggest a better understanding of alternatives to RBC transfusion, and identify the need for better evidence on hemoglobin thresholds that might be used in specific subpopulations of critically ill children.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 :

2019-12-09T16:48:54Z