842 Determinants of Red Blood Cell Transfusions in a Pediatric Critical Care Unit: A Prospective, Descriptive Epidemiological Study

Abstract

Objective: To determine the incidence and to cherecterize the determinants of red blood cell transfusions in critically ill children.

Sesign: Prospective, descriptive epidemiologic study.

Patients: Critically ill children.

Setting: A single-center, multidisciplinary, tertiary care level, university-affiliated, pediatric intensive care unit (PICU).

Interventions:

None.

Measurements and main results: Of 425 consecutive admissions over a 9 months period, 286 were retained for study. At least one transfusion was given in 52.3 % of cases. Incidence rate of transfusion was 688 transfusions/1.000 cases. Possible determinants of red blood cell transfusions were identified and prospectively monitored during PICU stay until a first transfusion event (transfused cases) or until the time of death or discharge from PICU (non-transfused cases). Three significant determinants of a first red blood cell transfusion event were retained in the multivariate analysis: a pre-transfusion hemoglobin level < 9.5 g/dL (OR: 35.97, CI: 10.B3-119.51, p < 0.0001), an admission diagnosis of cardiac disease (OR: 3.58, CI: 1.21- 10.55, p < 0.02), an admission Pediatric Logistic Organ Dysfunction (PELOD) score >20 (OR: 8.62, CI: 2.09-35.74, p < 0.0001).

Conclusion: A significant proportion of critically ill children receive at least one red blood cell transfusion during their PICU stay. Presence of anemia, cardiac disease, severe critical illness with multiple organ dysfunction syndromes are the most significant determinants of red blood cell transfusions in PICU.

Abbreviations: OR; odds ratio, CI; confidence interval.

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