How 217 Pediatric Intensivists Manage Anemia at PICU Discharge: Online Responses to an International Survey.

Détails

ID Serval
serval:BIB_2E9A948FF0C9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
How 217 Pediatric Intensivists Manage Anemia at PICU Discharge: Online Responses to an International Survey.
Périodique
Pediatric critical care medicine
Auteur(s)
Demaret P., Karam O., Labreuche Bst J., Chiusolo F., Mayordomo Colunga J., Erickson S., Nellis M.E., Perez M.H., Ray S., Tucci M., Willems A., Duhamel A., Lebrun F., Loeckx I., Mulder A., Leteurtre S.
Collaborateur(s)
Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP); the Pediatric Critical Care Blood Research Network (BloodNet); and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
ISSN
1529-7535 (Print)
ISSN-L
1529-7535
Statut éditorial
Publié
Date de publication
06/2020
Peer-reviewed
Oui
Volume
21
Numéro
6
Pages
e342-e353
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To describe the management of anemia at PICU discharge by pediatric intensivists.
Self-administered, online, scenario-based survey.
PICUs in Australia/New Zealand, Europe, and North America.
Pediatric intensivists.
None.
Respondents were asked to report their decisions regarding RBC transfusions, iron, and erythropoietin prescription to children ready to be discharged from PICU, who had been admitted for hemorrhagic shock, cardiac surgery, craniofacial surgery, and polytrauma. Clinical and biological variables were altered separately in order to assess their effect on the management of anemia. Two-hundred seventeen responses were analyzed. They reported that the mean (± SEM) transfusion threshold was a hemoglobin level of 6.9 ± 0.09 g/dL after hemorrhagic shock, 7.6 ± 0.10 g/dL after cardiac surgery, 7.0 ± 0.10 g/dL after craniofacial surgery, and 7.0 ± 0.10 g/dL after polytrauma (p < 0.001). The most important increase in transfusion threshold was observed in the presence of a cyanotic heart disease (mean increase ranging from 1.80 to 2.30 g/dL when compared with baseline scenario) or left ventricular dysfunction (mean increase, 1.41-2.15 g/dL). One third of respondents stated that they would not prescribe iron at PICU discharge, regardless of the hemoglobin level or the baseline scenario. Most respondents (69.4-75.0%, depending on the scenario) did not prescribe erythropoietin.
Pediatric intensivists state that they use restrictive transfusion strategies at PICU discharge similar to those they use during the acute phase of critical illness. Supplemental iron is less frequently prescribed than RBCs, and prescription of erythropoietin is uncommon. Optimal management of post-PICU anemia is currently unknown. Further studies are required to highlight the consequences of this anemia and to determine appropriate management.
Pubmed
Web of science
Création de la notice
01/04/2020 17:49
Dernière modification de la notice
18/12/2020 6:26
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