Consensus recommendations for rbc transfusion practice in critically Ill children from the pediatric critical care transfusion and Anemia expertise initiative

Stacey L. Valentine, Melania M. Bembea, Jennifer A. Muszynski, Jill M. Cholette, Allan Doctor, Phillip C. Spinella, Marie E Steiner, Marisa Tucci, Nabil E. Hassan, Robert I. Parker, Jacques Lacroix, Andrew Argent, Jeffrey L. Carson, Kenneth E. Remy, Pierre Demaret, Guillaume Emeriaud, Martin C.J. Kneyber, Nina Guzzetta, Mark W. Hall, Duncan Macrae & 22 others Oliver Karam, Robert T. Russell, Paul A. Stricker, Adam M. Vogel, Robert C. Tasker, Alexis F. Turgeon, Steven M. Schwartz, Ariane Willems, Cassandra D. Josephson, Naomi L.C. Luban, Leslie E. Lehmann, Simon J. Stanworth, Nicole D Zantek, Timothy E. Bunchman, Ira M. Cheifetz, James D. Fortenberry, Meghan Delaney, Leo Van De Watering, Karen A. Robinson, Sara Malone, Katherine M. Steffen, Scot T. Bateman

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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. Intervention: None. 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.

Original languageEnglish (US)
Pages (from-to)884-898
Number of pages15
JournalPediatric Critical Care Medicine
Volume19
Issue number9
DOIs
StatePublished - Jan 1 2018

Fingerprint

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

Keywords

  • Blood
  • Child
  • Consensus development conference
  • Pediatric critical care
  • Red blood cell
  • Transfusion

Cite this

Consensus recommendations for rbc transfusion practice in critically Ill children from the pediatric critical care transfusion and Anemia expertise initiative. / Valentine, Stacey L.; Bembea, Melania M.; Muszynski, Jennifer A.; Cholette, Jill M.; Doctor, Allan; Spinella, Phillip C.; Steiner, Marie E; Tucci, Marisa; Hassan, Nabil E.; Parker, Robert I.; Lacroix, Jacques; Argent, Andrew; Carson, Jeffrey L.; Remy, Kenneth E.; Demaret, Pierre; Emeriaud, Guillaume; Kneyber, Martin C.J.; Guzzetta, Nina; Hall, Mark W.; Macrae, Duncan; Karam, Oliver; Russell, Robert T.; Stricker, Paul A.; Vogel, Adam M.; Tasker, Robert C.; Turgeon, Alexis F.; Schwartz, Steven M.; Willems, Ariane; Josephson, Cassandra D.; Luban, Naomi L.C.; Lehmann, Leslie E.; Stanworth, Simon J.; Zantek, Nicole D; Bunchman, Timothy E.; Cheifetz, Ira M.; Fortenberry, James D.; Delaney, Meghan; Van De Watering, Leo; Robinson, Karen A.; Malone, Sara; Steffen, Katherine M.; Bateman, Scot T.

In: Pediatric Critical Care Medicine, Vol. 19, No. 9, 01.01.2018, p. 884-898.

Research output: Contribution to journalArticle

Valentine, SL, Bembea, MM, Muszynski, JA, Cholette, JM, Doctor, A, Spinella, PC, Steiner, ME, Tucci, M, Hassan, NE, Parker, RI, Lacroix, J, Argent, A, Carson, JL, Remy, KE, Demaret, P, Emeriaud, G, Kneyber, MCJ, Guzzetta, N, Hall, MW, Macrae, D, Karam, O, Russell, RT, Stricker, PA, Vogel, AM, Tasker, RC, Turgeon, AF, Schwartz, SM, Willems, A, Josephson, CD, Luban, NLC, Lehmann, LE, Stanworth, SJ, Zantek, ND, Bunchman, TE, Cheifetz, IM, Fortenberry, JD, Delaney, M, Van De Watering, L, Robinson, KA, Malone, S, Steffen, KM & Bateman, ST 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, vol. 19, no. 9, pp. 884-898. https://doi.org/10.1097/PCC.0000000000001613
Valentine, Stacey L. ; Bembea, Melania M. ; Muszynski, Jennifer A. ; Cholette, Jill M. ; Doctor, Allan ; Spinella, Phillip C. ; Steiner, Marie E ; Tucci, Marisa ; Hassan, Nabil E. ; Parker, Robert I. ; Lacroix, Jacques ; Argent, Andrew ; Carson, Jeffrey L. ; Remy, Kenneth E. ; Demaret, Pierre ; Emeriaud, Guillaume ; Kneyber, Martin C.J. ; Guzzetta, Nina ; Hall, Mark W. ; Macrae, Duncan ; Karam, Oliver ; Russell, Robert T. ; Stricker, Paul A. ; Vogel, Adam M. ; Tasker, Robert C. ; Turgeon, Alexis F. ; Schwartz, Steven M. ; Willems, Ariane ; Josephson, Cassandra D. ; Luban, Naomi L.C. ; Lehmann, Leslie E. ; Stanworth, Simon J. ; Zantek, Nicole D ; Bunchman, Timothy E. ; Cheifetz, Ira M. ; Fortenberry, James D. ; Delaney, Meghan ; Van De Watering, Leo ; Robinson, Karen A. ; Malone, Sara ; Steffen, Katherine M. ; Bateman, Scot T. / 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. 2018 ; Vol. 19, No. 9. pp. 884-898.
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abstract = "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. Intervention: None. 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.",
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author = "Valentine, {Stacey L.} and Bembea, {Melania M.} and Muszynski, {Jennifer A.} and Cholette, {Jill M.} and Allan Doctor and Spinella, {Phillip C.} and Steiner, {Marie E} and Marisa Tucci and Hassan, {Nabil E.} and Parker, {Robert I.} and Jacques Lacroix and Andrew Argent and Carson, {Jeffrey L.} and Remy, {Kenneth E.} and Pierre Demaret and Guillaume Emeriaud and Kneyber, {Martin C.J.} and Nina Guzzetta and Hall, {Mark W.} and Duncan Macrae and Oliver Karam and Russell, {Robert T.} and Stricker, {Paul A.} and Vogel, {Adam M.} and Tasker, {Robert C.} and Turgeon, {Alexis F.} and Schwartz, {Steven M.} and Ariane Willems and Josephson, {Cassandra D.} and Luban, {Naomi L.C.} and Lehmann, {Leslie E.} and Stanworth, {Simon J.} and Zantek, {Nicole D} and Bunchman, {Timothy E.} and Cheifetz, {Ira M.} and Fortenberry, {James D.} and Meghan Delaney and {Van De Watering}, Leo and Robinson, {Karen A.} and Sara Malone and Steffen, {Katherine M.} and Bateman, {Scot T.}",
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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 - Valentine, Stacey L.

AU - Bembea, Melania M.

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 - 2018/1/1

Y1 - 2018/1/1

N2 - 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. Intervention: None. 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.

AB - 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. Intervention: None. 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.

KW - Blood

KW - Child

KW - Consensus development conference

KW - Pediatric critical care

KW - Red blood cell

KW - Transfusion

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