What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding

Authors

Meghan Delaney, Division of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC.
Oliver Karam, Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, VA.
Lani Lieberman, Department of Clinical Pathology, University Health Network Hospitals, Toronto, ON, Canada.
Katherine Steffen, Department of Pediatrics, Division of Pediatric Critical Care Medicine, Stanford University, Palo Alto, CA.
Jennifer A. Muszynski, Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital and the Ohio State University College of Medicine, Columbus, OH.
Ruchika Goel, Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD.
Scot T. Bateman, Division of Pediatric Critical Care, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA.
Robert I. Parker, Department of Pediatric Hematology/Oncology, Renaissance School of Medicine, State University of New York at Stony Brook, Stony Brook, NY.
Marianne E. Nellis, Division of Pediatric Critical Care Medicine, Department of Pediatrics, NY Presbyterian Hospital-Weill Cornell Medicine, New York, NY.
Kenneth E. Remy, Department of Pediatrics, Division of Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Volume

23

Issue

13 Suppl 1 1S

DOI

10.1097/PCC.0000000000002854

Abstract

OBJECTIVES: To present consensus statements and supporting literature for plasma and platelet product variables and related laboratory testing for transfusions in general 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 10 experts developed evidence-based and, when evidence was insufficient, expert-based statements for laboratory testing and blood product attributes for platelet and plasma transfusions. These statements were reviewed and ratified by the 29 Transfusion and Anemia EXpertise Initiative - Control/Avoidance of Bleeding experts. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane Library databases, from inception to December 2020. Consensus was obtained using the Research and Development/University of California, Los Angeles Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method. We developed five expert consensus statements and two recommendations in answer to two questions: what laboratory tests and physiologic triggers should guide the decision to administer a platelet or plasma transfusion in critically ill children; and what product attributes are optimal to guide specific product selection? CONCLUSIONS: The Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding program provides some guidance and expert consensus for the laboratory and blood product attributes used for decision-making for plasma and platelet transfusions in critically ill pediatric patients.

APA Citation

Delaney, Meghan; Karam, Oliver; Lieberman, Lani; Steffen, Katherine; Muszynski, Jennifer A.; Goel, Ruchika; Bateman, Scot T.; Parker, Robert I.; Nellis, Marianne E.; and Remy, Kenneth E., "What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding" (2022). GW Authored Works. Paper 480.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/480

Department

Pathology