Paediatric palliative care: why transfuse?

Should indication for transfusion in paediatric palliative care be based on the child’s perspective rather than the biological results? An 8-year-old boy presenting a relapse of a stage IV neuroblastoma received regular blood transfusions. A severe exophtalmia led the doctors to question the transfusion strategy. Over 7.5 months, the child received 56 red blood cell units and 31 platelet units. He was hospitalised 50 times. Indication for blood test and transfusion may be regularly and collegially reassessed. Transfusion needs in a palliative strategy can be as high as in a curative strategy. Practices, benefits but also ethical and public health dimensions should be more studied.

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Mortality and morbidity of low-grade red blood cell transfusions in septic patients: a propensity score-matched observational study of a liberal transfusion strategy

Annals of Intensive Care ◽

10.1186/s13613-020-00727-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Caroline Ulfsdotter Nilsson ◽

Peter Bentzer ◽

Linnéa E. Andersson ◽

Sofia A. Björkman ◽

Fredrik P. Hanssson ◽

...

Keyword(s):

Propensity Score ◽

Observational Study ◽

Blood Cell ◽

Red Blood Cell ◽

Low Grade ◽

Transfusion Strategy ◽

Mortality And Morbidity ◽

Red Blood Cell Transfusions ◽

Liberal Transfusion

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Using arterial-venous oxygen difference to guide red blood cell transfusion strategy

Critical Care ◽

10.1186/s13054-020-2827-5 ◽

2020 ◽

Vol 24 (1) ◽

Cited By ~ 1

Author(s):

Alberto Fogagnolo ◽

Fabio Silvio Taccone ◽

Jean Louis Vincent ◽

Giulia Benetto ◽

Elaine Cavalcante ◽

...

Keyword(s):

Blood Cell ◽

Red Blood Cell ◽

Red Blood Cell Transfusion ◽

Transfusion Strategy ◽

Oxygen Difference

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BLOOD TRANSFUSION IN CARDIAC SURGERY- NEED TO FOLLOW BASICS!

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0703.01 ◽

2020 ◽

Vol 7 (3) ◽

Keyword(s):

Cardiac Surgery ◽

Blood Transfusion ◽

Blood Cell ◽

Red Blood Cell ◽

Red Blood Cell Transfusion ◽

Transfusion Strategy ◽

Transfusion Threshold ◽

Restrictive Transfusion ◽

Conflicting Evidence ◽

American Society

More and more data is coming in recent times about hazards of blood transfusion. In a landmark TRICC1 trial Euvolemic patients in the intensive care unit (ICU) with Hb<9 g/dl were randomized to a restrictive transfusion strategy for transfusion of PRBCs (transfused if Hb<7 g/dl to maintain Hb between 7 and 9 g/dl) or a liberal strategy (transfused if Hb<10 g/dl to maintain Hb 10-12 g/dl). Mortality was similar in both groups, indicating that liberal transfusions were not beneficial. An Updated Report by the American Society of AnaesthesiologistsTask Force on Perioperative Blood Management tells us restrictive red blood cell transfusion strategy may be safely used to reduce transfusion administration. It further states that The determination of whether hemoglobin concentrations between 6 and 10 g/dl justify or require red blood cell transfusion should be based on potential or actual on going bleeding (rate and magnitude), intravascular volume status, signs of organ ischemia, and adequacy of cardiopulmonary reserve. Should we extrapolate these guidelines in Cardiac surgery? TRACS2 trial concluded that among patients undergoing cardiac surgery, the use of a restrictive perioperative transfusion strategy compared with a more liberal strategy resulted in noninferior rates of the combined outcome of 30-day all-cause mortality and severe morbidity.They advocated use of restrictive strategy, but 5 years later, the authors 3concluded that A restrictive transfusion threshold after cardiac surgery was not superior to a liberal threshold with respect to morbidity or health care costs. With this conflicting evidence, by which way anaesthesiologist to go?

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Increased Red Blood Cell Distribution Width Is Associated With Greater Risk of All-Cause, Cardiovascular and Non-Cardiovascular Mortality in a Large Community-Based Cohort

Circulation ◽

10.1161/circ.118.suppl_18.a_29-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Todd Perlstein

Keyword(s):

Public Health ◽

Blood Cell ◽

Red Blood Cell ◽

Cardiovascular Mortality ◽

Cell Distribution ◽

Community Based ◽

Distribution Width ◽

Large Community ◽

Red Blood Cell Distribution

Abstract 1253 Todd S Perlstein, Brigham and Women’s Hosp, Boston, MA; Jennifer Weuve, Harvard Sch of Public Health, Boston, MA; Marc A Pfeffer, Joshua A Beckman, Brigham and Women’s Hosp, Boston, MA Todd Perlstein, 2008 Finalist and Presenting Author

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