Transfusion Decision Making in Pediatric Critical Illness

Chris Markham, Peter Hovmand, Allan Doctor

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Transfusion decision making (TDM) in the critically ill requires consideration of: (1) anemia tolerance, which is linked to active pathology and to physiologic reserve, (2) differences in donor RBC physiology from that of native RBCs, and (3) relative risk from anemia-attributable oxygen delivery failure vs hazards of transfusion, itself. Current approaches to TDM (e.g. hemoglobin thresholds) do not: (1) differentiate between patients with similar anemia, but dissimilar pathology/physiology, and (2) guide transfusion timing and amount to efficacy-based goals (other than resolution of hemoglobin thresholds). Here, we explore approaches to TDM that address the above gaps.

Original languageEnglish
Pages (from-to)991-1015
Number of pages25
JournalPediatric Clinics of North America
Volume64
Issue number5
DOIs
StatePublished - Oct 2017

Keywords

  • Anemia
  • Precision medicine
  • Systems dynamics
  • Transfusion decision making

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