Research Priorities for Plasma and Platelet Transfusion Strategies in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding

Marianne E. Nellis, Kenneth E. Remy, Jacques Lacroix, Jill M. Cholette, Melania M. Bembea, Robert T. Russell, Marie E. Steiner, Susan M. Goobie, Adam M. Vogel, Gemma Crighton, Stacey L. Valentine, Meghan Delaney, Robert I. Parker

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

OBJECTIVES: To present a list of high-priority research initiatives for the study of plasma and platelet transfusions in critically ill children from the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. DESIGN: Systematic review and consensus conference of international, multidisciplinary experts in platelet and plasma transfusion management of critically ill children. SETTING: Not applicable. PATIENTS: Critically ill pediatric patients at risk of bleeding and receiving plasma and/or platelet transfusions. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A panel of 13 experts developed research priorities for the study of plasma and platelet transfusions in critically ill children which were reviewed and ratified by the 29 Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding experts. The specific priorities focused on the following subpopulations: severe trauma, traumatic brain injury, intracranial hemorrhage, cardiopulmonary bypass surgery, extracorporeal membrane oxygenation, oncologic diagnosis or stem cell transplantation, acute liver failure and/or liver transplantation, noncardiac surgery, invasive procedures outside of the operating room, and sepsis and/or disseminated intravascular coagulation. In addition, tests to guide plasma and platelet transfusion, as well as component selection and processing, were addressed. We developed four general overarching themes and 14 specific research priorities using modified Research and Development/University of California, Los Angeles methodology. CONCLUSIONS: Studies are needed to focus on the efficacy/harm, dosing, timing, and outcomes of critically ill children who receive plasma and/or platelet transfusions. The completion of these studies will facilitate the development of evidence-based recommendations.

Original languageEnglish (US)
Pages (from-to)E63-E73
JournalPediatric Critical Care Medicine
Volume23
Issue numberSupplement 1 1S
DOIs
StatePublished - Jan 1 2022

Bibliographical note

Funding Information:
Dr. Bembea’s institution received funding from the National Institute of Neurological Disorders and Stroke (R01NS106292), the National Institute of Child Health and Human Development, and Grifols Investigator Sponsored Research Grant. Drs. Bembea and Russell received support for article research from the National Institutes of Health. Dr. Steiner received funding from Pumps for Kids, Infants, and Neonates (PumpKIN) Data Safety and Monitoring Board and HealthCore. Dr. Crighton disclosed that she is employed by the Royal Children’s Hospital of Melbourne, Australia and was the Australian and New Zealand Society of Blood Transfusion President. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Funding Information:
The Transfusion and Anemia EXpertise Initiative–Control/Avoidance of Bleeding was supported, in part, by the National Institutes of Health National Heart, Lung and Blood Institute under award number R13 HL154544-01.

Funding Information:
We would like to thank all members of the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding for their support and input, especially during the coronavirus disease 2019 pandemic. In addition, we thank the Chaire H?ma-Qu?bec-Bayer en m?decine transfusionnelle de l'Universit? de Montr?al, the Society for the Advancement of Blood Management, the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis, the International Society of Blood Transfusion, the Society for Critical Care Medicine, and the AABB for their support.

Publisher Copyright:
© 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Keywords

  • Child
  • Coagulopathy
  • Critical illness
  • Hemostasis
  • Plasma
  • Platelet transfusion

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

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