Abstract
\nOBJECTIVE: To determine the impact of a restrictive vs. a liberal transfusion strategy on new or progressive multiple organ dysfunction syndrome in children post cardiac surgery. The optimal transfusion threshold after cardiac surgery in children is unknown.<\/p>\n

DESIGN: Randomized, controlled trial.<\/p>\n

SETTING: Tertiary pediatric intensive care units.<\/p>\n

PATIENTS: Participants are a subgroup of pediatric patients post cardiac surgery from the TRIPICU (Transfusion Requirements in Pediatric Intensive Care Units) study. Exclusion criteria specific to the cardiac surgery subgroup included: age <28 days and patients remaining cyanotic.\n\nINTERVENTION: Critically ill children with a hemoglobin < or = 95 g\/L within 7 days of pediatric intensive care unit admission were randomized to receive prestorage leukocyte-reduced red-cell transfusion if their hemoglobin dropped either <70 g\/L (restrictive) or 95 g\/L (liberal).\n\nMEASUREMENTS AND MAIN RESULTS: Postoperative cardiac patients (n = 125) from seven centers were enrolled. The restrictive (n = 63) and liberal (n = 62) groups were similar at baseline in age (mean +\/- standard deviation = 31.4 +\/- 38.1 mos vs. 26.4 +\/- 39.1 mos), surgical procedure, severity of illness (Pediatric Risk of Mortality score = 3.4 +\/- 3.2 vs. 3.2 +\/- 3.2), multiple organ dysfunction syndrome (46% vs. 44%), mechanical ventilation (62% vs. 60%), and hemoglobin (83 vs. 80 g\/L). Mean hemoglobin remained 21 g\/L lower in the restrictive group after randomization. No significant difference was found in new or progressive multiple organ dysfunction syndrome (primary outcome) in the restrictive group vs. liberal group (12.7% vs. 6.5%; p = .36), pediatric intensive care unit length of stay (7.0 +\/- 5.0 days vs. 7.4 +\/- 6.4 days) or 28-day mortality (3.2% vs. 3.2%).\n\nCONCLUSION: In this subgroup analysis of cardiac surgery patients, a restrictive red-cell transfusion strategy, as compared with a liberal one, was not associated with any significant difference in new or progressive multiple organ dysfunction syndrome, but this evidence is not definitive.\n\nPMID: 19789443 [PubMed - indexed for MEDLINE]\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Editorial: Crit Care Med Fecha: 01\/02\/2010 Willems A, Harrington K, Lacroix J, Biarent D, Joffe AR, Wensley D, Ducruet T,<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[4],"tags":[],"_links":{"self":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/391"}],"collection":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/comments?post=391"}],"version-history":[{"count":1,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/391\/revisions"}],"predecessor-version":[{"id":690,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/391\/revisions\/690"}],"wp:attachment":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/media?parent=391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/categories?post=391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/tags?post=391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}