Meghan Delaney1,2, Oliver Karam3, Lani Lieberman4,5, Katherine Steffen6, Jennifer A Muszynski7, Ruchika Goel8, Scot T Bateman9, Robert I Parker10, Marianne E Nellis11, Kenneth E Remy12. 1. Division of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC. 2. Department of Pathology and Pediatrics, The George Washington University Health Sciences, Washington, DC. 3. Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, VA. 4. Department of Clinical Pathology, University Health Network Hospitals, Toronto, ON, Canada. 5. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. 6. Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stanford University, Palo Alto, CA. 7. Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, OH. 8. Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD. 9. Division of Pediatric Critical Care, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA. 10. Department of Pediatric Hematology/Oncology, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, NY. 11. Division of Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyterian Hospital-Weill Cornell Medicine, New York, NY. 12. Department of Pediatrics, Division of Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO.
Abstract
OBJECTIVES: To present consensus statements and supporting literature for plasma and platelet product variables and related laboratory testing for transfusions in general critically ill children from the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. DESIGN: Systematic review and consensus conference of international, multidisciplinary experts in platelet and plasma transfusion management of critically ill children. SETTING: Not applicable. PATIENTS: Critically ill pediatric patients at risk of bleeding and receiving plasma and/or platelet transfusions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A panel of 10 experts developed evidence-based and, when evidence was insufficient, expert-based statements for laboratory testing and blood product attributes for platelet and plasma transfusions. These statements were reviewed and ratified by the 29 Transfusion and Anemia EXpertise Initiative - Control/Avoidance of Bleeding experts. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane Library databases, from inception to December 2020. Consensus was obtained using the Research and Development/University of California, Los Angeles Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed five expert consensus statements and two recommendations in answer to two questions: what laboratory tests and physiologic triggers should guide the decision to administer a platelet or plasma transfusion in critically ill children; and what product attributes are optimal to guide specific product selection? CONCLUSIONS: The Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding program provides some guidance and expert consensus for the laboratory and blood product attributes used for decision-making for plasma and platelet transfusions in critically ill pediatric patients.
OBJECTIVES: To present consensus statements and supporting literature for plasma and platelet product variables and related laboratory testing for transfusions in general critically ill children from the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. DESIGN: Systematic review and consensus conference of international, multidisciplinary experts in platelet and plasma transfusion management of critically ill children. SETTING: Not applicable. PATIENTS: Critically ill pediatric patients at risk of bleeding and receiving plasma and/or platelet transfusions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A panel of 10 experts developed evidence-based and, when evidence was insufficient, expert-based statements for laboratory testing and blood product attributes for platelet and plasma transfusions. These statements were reviewed and ratified by the 29 Transfusion and Anemia EXpertise Initiative - Control/Avoidance of Bleeding experts. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane Library databases, from inception to December 2020. Consensus was obtained using the Research and Development/University of California, Los Angeles Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed five expert consensus statements and two recommendations in answer to two questions: what laboratory tests and physiologic triggers should guide the decision to administer a platelet or plasma transfusion in critically ill children; and what product attributes are optimal to guide specific product selection? CONCLUSIONS: The Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding program provides some guidance and expert consensus for the laboratory and blood product attributes used for decision-making for plasma and platelet transfusions in critically ill pediatric patients.
Authors: Helen V New; Simon J Stanworth; Ruth Gottstein; Carol Cantwell; Jennifer Berryman; Elizabeth A Chalmers; Paula H B Bolton-Maggs Journal: Br J Haematol Date: 2020-11-18 Impact factor: 6.998
Authors: F Norol; P Bierling; F Roudot-Thoraval; F F Le Coeur; C Rieux; A Lavaux; M Kuentz; N Duedari Journal: Blood Date: 1998-08-15 Impact factor: 22.113
Authors: Marianne E Nellis; Oliver Karam; Stacey L Valentine; Scot T Bateman; Kenneth E Remy; Jacques Lacroix; Jill M Cholette; Melania M Bembea; Robert T Russell; Marie E Steiner; Susan M Goobie; Marisa Tucci; Paul A Stricker; Simon J Stanworth; Meghan Delaney; Lani Lieberman; Jennifer A Muszynski; David F Bauer; Katherine Steffen; Daniel Nishijima; Juan Ibla; Sitaram Emani; Adam M Vogel; Thorsten Haas; Ruchika Goel; Gemma Crighton; Diana Delgado; Michelle Demetres; Robert I Parker Journal: Pediatr Crit Care Med Date: 2022-01-01 Impact factor: 3.624