Indications and Effects of Plasma Transfusions in Critically Ill Children.


Serval ID
Article: article from journal or magazin.
Indications and Effects of Plasma Transfusions in Critically Ill Children.
American journal of respiratory and critical care medicine
Karam O., Demaret P., Shefler A., Leteurtre S., Spinella P.C., Stanworth S.J., Tucci M.
Working group(s)
Canadian Critical Care Trials Group (CCCTG), Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), BloodNet, PlasmaTV Investigators
Butt W., Delzoppo C., Bain K., Erickson S., Smalley N., Dorofaeff T., Long D., Smalley N., Wiseman G., de Cléty S.C., Berghe C., de Jaeger A., Demaret P., Trippaerts M., Willems A., Rooze S., De Dooy J., Gilfoyle E., Wohlgemuth L., Tucci M., Dumitrascu M., Withington D., Hickey J., Choong K., Sanders L., Morrison G., Tijssen J., Wensley D., Krahn G., Dugas M.A., Gosselin L., Santschi M., Von Dessauer B., Ordenes N., Afshari A., Andersen L.H., Nilsson J.C., Johansen M., Jensen A.M., Mino S.C., Grunauer M., Joram N., Roullet-Renoleau N., Javouhey E., Cour-Andlauer F., Portefaix A., Brissaud O., Guichoux J., Payen V., Léger P.L., Afanetti M., Mortamet G., Maria M., Breining A., Tissieres P., e Dorkenoo A., Deho A., Steinherr H., Nikolaou F., Camporesi A., Mario F., Kawasaki T., Miura S., Beca J., Rea M., Sherring C., Bushell T., Bentsen G., Dinis A., Pereira G., Vieira M., Moniz M., Alshehri S., Alasnag M., Rajab A., Pisarcikova M., Jordan I., Balcells J., Perez-Ferrer A., de Vicente Sánchez J., Moyano M.V., Martinez A.M., Lopez-Herce J., Solana M.J., González J.C., Alonso M.T., Faza M.N., Perez M.H., Amiet V., Doell C., Bordessoule A., Otter S.C., Kapitein B., Kneyber M., Brierley J., Rea V., McKeever S., Kelleher A., Scholefield B., Top A., Kelly N., Virdee S., Davis P., George S., Hawkins K.C., Hudnott P., Brown V., Sykes K., Levin R., MacLeod I., Horan M., Jirasek P., Inwald D., Abdulla A., Raghunanan S., Taylor B., Shefler A., Sparkes H., Hanson S., Woods K., Triscari D., Murkowski K., Ozment C., Steiner M., Nerheim D., Galster A., Higgerson R., Christie L., Spinella P., Martin D., Rourke L., Muszynski J., Steele L., Ajizian S., McCrory M., O'Brien K., Babbitt C., Felkel E., Levine G., Truemper E.J., Zink M., Nellis M., Thomas N.J., Spear D., Markovitz B., Terry J., Morzov R., Montgomery V., Michael A., Thomas M., Singleton M., Jarvis D., Nett S., Willson D., Hoot M., Bembea M., Yiu A., McKinley D., Scarlett E., Sankey J., Parikh M., Faustino E.V., Michelson K., Rilinger J., Campbell L., Gertz S., Cholette J.M., Jeyapalan A., Parker M., Bateman S., Johnson A.
1535-4970 (Electronic)
Publication state
Issued date
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Plasma transfusions are frequently prescribed for critically ill children, although their indications lack a strong evidence base. Plasma transfusions are largely driven by physician conceptions of need, and these are poorly documented in pediatric intensive care patients.
To identify patient characteristics and to characterize indications leading to plasma transfusions in critically ill children, and to assess the effect of plasma transfusions on coagulation tests.
Point-prevalence study in 101 pediatric intensive care units in 21 countries, on 6 predefined weeks. All critically ill children admitted to a participating unit were included if they received at least one plasma transfusion.
During the 6 study weeks, 13,192 children were eligible. Among these, 443 (3.4%) received at least one plasma transfusion and were included. The primary indications for plasma transfusion were critical bleeding in 22.3%, minor bleeding in 21.2%, planned surgery or procedure in 11.7%, and high risk of postoperative bleeding in 10.6%. No bleeding or planned procedures were reported in 34.1%. Before plasma transfusion, the median international normalized ratio (INR) and activated partial thromboplastin time (aPTT) values were 1.5 and 48, respectively. After plasma transfusion, the median INR and aPTT changes were -0.2 and -5, respectively. Plasma transfusion significantly improved INR only in patients with a baseline INR greater than 2.5.
One-third of transfused patients were not bleeding and had no planned procedure. In addition, in most patients, coagulation tests are not sensitive to increases in coagulation factors resulting from plasma transfusion. Studies assessing appropriate plasma transfusion strategies are urgently needed.

Adolescent, Analysis of Variance, Blood Component Transfusion/statistics & numerical data, Canada, Child, Child, Preschool, Critical Care/statistics & numerical data, Critical Illness, Cross-Sectional Studies, Europe, Female, Hemorrhage/therapy, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric/statistics & numerical data, International Normalized Ratio/statistics & numerical data, Male, Partial Thromboplastin Time/statistics & numerical data, blood coagulation tests, blood transfusion, child, critical illness, plasma
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01/05/2018 8:19
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20/08/2019 14:05
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