Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS
Introduction. In the first 48 hours of ventilating patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), a multipronged approach including packed red blood cell (PRBC) transfusion is undertaken to maintain oxygen delivery. Hypothesis. We hypothesized children with ALI/ARD...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/646473 |
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| author | Surender Rajasekaran Dominic Sanfilippo Allen Shoemaker Scott Curtis Sandra Zuiderveen Akunne Ndika Michael Stoiko Nabil Hassan |
| author_facet | Surender Rajasekaran Dominic Sanfilippo Allen Shoemaker Scott Curtis Sandra Zuiderveen Akunne Ndika Michael Stoiko Nabil Hassan |
| author_sort | Surender Rajasekaran |
| collection | DOAJ |
| description | Introduction. In the first 48 hours of ventilating patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), a multipronged approach including packed red blood cell (PRBC) transfusion is undertaken to maintain oxygen delivery. Hypothesis. We hypothesized children with ALI/ARDS transfused within 48 hours of initiating mechanical ventilation would have worse outcome. The course of 34 transfused patients was retrospectively compared to 45 nontransfused control patients admitted to the PICU at Helen DeVos Children’s Hospital between January 1st 2008 and December 31st 2009. Results. Mean hemoglobin (Hb) prior to transfusion was 8.2 g/dl compared to 10.1 g/dl in control. P/F ratio decreased from 135.4±7.5 to 116.5±8.8 in transfused but increased from 148.0±8.0 to 190.4±17.8 (P<0.001) in control. OI increased in the transfused from 11.7±0.9 to 18.7±1.6 but not in control. Ventilator days in the transfused were 15.6±1.7 versus 9.5±0.6 days in control (P<0.001). There was a trend towards higher rates of MODS in transfused patients; 29.4% versus 17.7%, odds ratio 1.92, 95% CI; 0.6–5.6 Fisher exact P<0.282. Conclusion. This study suggests that early transfusions of patients with ALI/ARDS were associated with increased ventilatory needs. |
| format | Article |
| id | doaj-art-d2d09f5167a34cf59c9dedf9f969133b |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-d2d09f5167a34cf59c9dedf9f969133b2025-02-03T01:23:47ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/646473646473Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDSSurender Rajasekaran0Dominic Sanfilippo1Allen Shoemaker2Scott Curtis3Sandra Zuiderveen4Akunne Ndika5Michael Stoiko6Nabil Hassan7Division of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USAResearch Department, Grand Rapids Medical Education Partners, 1000 Monroe NW, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USADivision of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USAIntroduction. In the first 48 hours of ventilating patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), a multipronged approach including packed red blood cell (PRBC) transfusion is undertaken to maintain oxygen delivery. Hypothesis. We hypothesized children with ALI/ARDS transfused within 48 hours of initiating mechanical ventilation would have worse outcome. The course of 34 transfused patients was retrospectively compared to 45 nontransfused control patients admitted to the PICU at Helen DeVos Children’s Hospital between January 1st 2008 and December 31st 2009. Results. Mean hemoglobin (Hb) prior to transfusion was 8.2 g/dl compared to 10.1 g/dl in control. P/F ratio decreased from 135.4±7.5 to 116.5±8.8 in transfused but increased from 148.0±8.0 to 190.4±17.8 (P<0.001) in control. OI increased in the transfused from 11.7±0.9 to 18.7±1.6 but not in control. Ventilator days in the transfused were 15.6±1.7 versus 9.5±0.6 days in control (P<0.001). There was a trend towards higher rates of MODS in transfused patients; 29.4% versus 17.7%, odds ratio 1.92, 95% CI; 0.6–5.6 Fisher exact P<0.282. Conclusion. This study suggests that early transfusions of patients with ALI/ARDS were associated with increased ventilatory needs.http://dx.doi.org/10.1155/2012/646473 |
| spellingShingle | Surender Rajasekaran Dominic Sanfilippo Allen Shoemaker Scott Curtis Sandra Zuiderveen Akunne Ndika Michael Stoiko Nabil Hassan Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS Critical Care Research and Practice |
| title | Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS |
| title_full | Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS |
| title_fullStr | Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS |
| title_full_unstemmed | Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS |
| title_short | Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS |
| title_sort | respiratory impairment after early red cell transfusion in pediatric patients with ali ards |
| url | http://dx.doi.org/10.1155/2012/646473 |
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