Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative

Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI), Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network

Research output: Contribution to journalArticle

Abstract

SUBJECTS: Children with, or children at risk for, critical illness who receive or are at risk for receiving a RBC transfusion.

METHODS: A panel of 38 content and four methodology experts met over the course of 2 years to develop evidence-based, and when evidence lacking, expert consensus-based recommendations regarding decision-making for RBC transfusion management and research priorities for transfusion in critically ill children. The experts focused on nine specific populations of critically ill children: general, respiratory failure, nonhemorrhagic shock, nonlife-threatening bleeding or hemorrhagic shock, acute brain injury, acquired/congenital heart disease, sickle cell/oncology/transplant, extracorporeal membrane oxygenation/ventricular assist/ renal replacement support, and alternative processing. Data to formulate evidence-based and expert consensus recommendations were selected based on searches of PubMed, EMBASE, and Cochrane Library 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.

MEASUREMENTS AND RESULTS: The Transfusion and Anemia Expertise Initiative consensus conference developed and reached consensus on a total of 102 recommendations (57 clinical [20 evidence based, 37 expert consensus], 45 research recommendations). All final recommendations met agreement, defined a priori as greater than 80%. A decision tree to aid clinicians was created based on the clinical recommendations.

CONCLUSIONS: The Transfusion and Anemia Expertise Initiative recommendations provide important clinical guidance and applicable tools to avoid unnecessary RBC transfusions. Research recommendations identify areas of focus for future investigation to improve outcomes and safety for RBC transfusion.

OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.

DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children.

SETTING: Not applicable.None.

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Critical Care
Critical Illness
Anemia
Consensus
Pediatrics
Research
Decision Making
Decision Trees
Extracorporeal Membrane Oxygenation
Hemorrhagic Shock
PubMed
Respiratory Insufficiency
Brain Injuries
Libraries
Heart Diseases
Shock
Guidelines
Hemorrhage
Transplants
Kidney

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI), & Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network (2018). Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 19(9), 884-898. https://doi.org/10.1097/PCC.0000000000001613

Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. / Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI); Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network.

In: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, Vol. 19, No. 9, 01.09.2018, p. 884-898.

Research output: Contribution to journalArticle

Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI) & Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network 2018, 'Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative', Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 19, no. 9, pp. 884-898. https://doi.org/10.1097/PCC.0000000000001613
Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI), Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2018 Sep 1;19(9):884-898. https://doi.org/10.1097/PCC.0000000000001613
Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI) ; Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. / Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. In: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2018 ; Vol. 19, No. 9. pp. 884-898.
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TY - JOUR

T1 - Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative

AU - Pediatric Critical Care Transfusion and Anemia Expertise Initiative (TAXI)

AU - Pediatric Critical Care Blood Research Network (BloodNet), and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network

AU - Valentine, Stacey L.

AU - Bembea, Melania

AU - Muszynski, Jennifer A.

AU - Cholette, Jill M.

AU - Doctor, Allan

AU - Spinella, Phillip C.

AU - Steiner, Marie E.

AU - Tucci, Marisa

AU - Hassan, Nabil E.

AU - Parker, Robert I.

AU - Lacroix, Jacques

AU - Argent, Andrew

AU - Carson, Jeffrey L.

AU - Remy, Kenneth E.

AU - Demaret, Pierre

AU - Emeriaud, Guillaume

AU - Kneyber, Martin C.J.

AU - Guzzetta, Nina

AU - Hall, Mark W.

AU - Macrae, Duncan

AU - Karam, Oliver

AU - Russell, Robert T.

AU - Stricker, Paul A.

AU - Vogel, Adam M.

AU - Tasker, Robert C.

AU - Turgeon, Alexis F.

AU - Schwartz, Steven M.

AU - Willems, Ariane

AU - Josephson, Cassandra D.

AU - Luban, Naomi L.C.

AU - Lehmann, Leslie E.

AU - Stanworth, Simon J.

AU - Zantek, Nicole D.

AU - Bunchman, Timothy E.

AU - Cheifetz, Ira M.

AU - Fortenberry, James D.

AU - Delaney, Meghan

AU - van de Watering, Leo

AU - Robinson, Karen A

AU - Malone, Sara

AU - Steffen, Katherine M.

AU - Bateman, Scot T.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - SUBJECTS: Children with, or children at risk for, critical illness who receive or are at risk for receiving a RBC transfusion.METHODS: A panel of 38 content and four methodology experts met over the course of 2 years to develop evidence-based, and when evidence lacking, expert consensus-based recommendations regarding decision-making for RBC transfusion management and research priorities for transfusion in critically ill children. The experts focused on nine specific populations of critically ill children: general, respiratory failure, nonhemorrhagic shock, nonlife-threatening bleeding or hemorrhagic shock, acute brain injury, acquired/congenital heart disease, sickle cell/oncology/transplant, extracorporeal membrane oxygenation/ventricular assist/ renal replacement support, and alternative processing. Data to formulate evidence-based and expert consensus recommendations were selected based on searches of PubMed, EMBASE, and Cochrane Library 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.MEASUREMENTS AND RESULTS: The Transfusion and Anemia Expertise Initiative consensus conference developed and reached consensus on a total of 102 recommendations (57 clinical [20 evidence based, 37 expert consensus], 45 research recommendations). All final recommendations met agreement, defined a priori as greater than 80%. A decision tree to aid clinicians was created based on the clinical recommendations.CONCLUSIONS: The Transfusion and Anemia Expertise Initiative recommendations provide important clinical guidance and applicable tools to avoid unnecessary RBC transfusions. Research recommendations identify areas of focus for future investigation to improve outcomes and safety for RBC transfusion.OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children.SETTING: Not applicable.None.

AB - SUBJECTS: Children with, or children at risk for, critical illness who receive or are at risk for receiving a RBC transfusion.METHODS: A panel of 38 content and four methodology experts met over the course of 2 years to develop evidence-based, and when evidence lacking, expert consensus-based recommendations regarding decision-making for RBC transfusion management and research priorities for transfusion in critically ill children. The experts focused on nine specific populations of critically ill children: general, respiratory failure, nonhemorrhagic shock, nonlife-threatening bleeding or hemorrhagic shock, acute brain injury, acquired/congenital heart disease, sickle cell/oncology/transplant, extracorporeal membrane oxygenation/ventricular assist/ renal replacement support, and alternative processing. Data to formulate evidence-based and expert consensus recommendations were selected based on searches of PubMed, EMBASE, and Cochrane Library 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.MEASUREMENTS AND RESULTS: The Transfusion and Anemia Expertise Initiative consensus conference developed and reached consensus on a total of 102 recommendations (57 clinical [20 evidence based, 37 expert consensus], 45 research recommendations). All final recommendations met agreement, defined a priori as greater than 80%. A decision tree to aid clinicians was created based on the clinical recommendations.CONCLUSIONS: The Transfusion and Anemia Expertise Initiative recommendations provide important clinical guidance and applicable tools to avoid unnecessary RBC transfusions. Research recommendations identify areas of focus for future investigation to improve outcomes and safety for RBC transfusion.OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children.SETTING: Not applicable.None.

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