Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009
Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009
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DOI：
10.1111/j.1537-2995.2010.02708.x
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发表时间：
2010-11-01
期刊：
影响因子：
2.9
通讯作者：
Lacroix, Jacques
中科院分区：
文献类型：
--
作者：
Spinella, Philip C.;Dressler, Alex;Lacroix, Jacques
背景技术背景：先前的调查报告了特定儿科人群中输血实践或政策的变化。我们的目的是确定美国和加拿大儿童医院针对新生儿和儿科一般人群的现行输血政策。美国和加拿大血库（BB）对2008年10月至2009年1月期间在儿童医院提供血液制品的人员进行了调查。在美国和加拿大的90家儿童医院中，51（56.7%）血库或其指定人员回答。美国42/51（82.4%），（17.6%）来自加拿大66.6%的人认为红细胞储存时间对结果有影响的受访者对重症儿童的前瞻性随机试验感兴趣。根据患者年龄和临床状况的红细胞在美国，33名受访者中有28名（84 8%）提供了普遍的红细胞白细胞减少，而在加拿大，9名受访者中有9名（100%）提供了红细胞白细胞减少。结论：在美国和加拿大的儿童医院中，BB关于RBC输注的政策存在很大差异。需要进行前瞻性随机对照试验，以制定关于RBC输注的循证护理标准。
BACKGROUND: Previous surveys have reported variation in transfusion practice or policies in specific pediatric populations Our objective was to determine the current transfusion policies in US and Canadian children's hospitals for both neonatal and pediatric general populationsSTUDY DESIGN AND METHODS: US and Canadian blood bank (BB) personnel at children's hospitals that provide blood products between the dates of October 2008 and January 2009 were surveyed.RESULTS: Of the 90 US and Canadian children's hospitals identified, 51 (56.7%) blood bankers or their designees responded There were 42 of 51 (82 4%) respondents from the United States and 9 of 51 (17.6%) from Canada There was wide variation in beliefs regarding the effect of red blood cell (RBC) storage age on outcomes with 66 6% of respondents interested in a prospective randomized trial in critically ill children There was also wide variation in policies restricting the storage age of RBCs according to patient age and clinical condition In the United States 28 of 33 (84 8%) respondents provide universal leukoreduction of RBCs whereas it is 9 of 9 (100%) in Canada Variation of policies existed for RBC irradiation and washing The majority of respondents indicated that RBC transfusions were audited if the pretransfusion hemoglobin level was more than 8 to 10 mg/dL Fresh whole blood is available at 6 of 40 (15%) responding children's hospitalsCONCLUSIONS: There is a wide variation in BB policies regarding RBC transfusions at children's hospitals in the United States and Canada Prospective randomized controlled trials are needed to allow for evidence-based standards of care regarding RBC transfusions