Intraoperative transfusion practice in burned children in a university hospital over four years: a retrospective analysis

Publication type:
Journal article
Metadata:
Abstract
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Patient blood management programs should be applied to the pediatric population, but little is known about the current transfusion practice of pediatric burn injury patients. This retrospective study was performed to evaluate the practice of red blood cell (RBC) transfusion in children with burn injury, their predictive factors, and adherence to the German transfusion guideline.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We reviewed the RBC transfusion practice of all children younger than 8 years with burn injury who were operated during a four-year period in a German university medical center. We analyzed the data associated with transfusion and guideline conformity of transfusion triggers for RBCs from the beginning to the end of hospital stay using logistic regression.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>During the four-year period, 138 children (median age 21 months, minimum-maximum 9–101 months) with burn injury needed surgery, 31 children were transfused with RBCs. During their hospital stay, the median hemoglobin concentrations (Hb) of transfused and non-transfused children were 8 g/dL (6.3–11.3 g/dL) and 10.7 (7–13.8 g/dL), respectively. Total body surface area burned (TBSA) (OR = 1.17 per % TBSA, 95% CI = [1.05; 1.30], <jats:italic>p</jats:italic> = 0.0056), length of surgery (OR = 1.016 per minute, 95% CI = [1.003; 1.028], <jats:italic>p</jats:italic> = 0.0150), and Hb (OR = 0.48 per 1 g/dl in Hb, 95% CI = [0.24; 0.95], <jats:italic>p</jats:italic> = 0.0343) were associated with transfusion while other factors (age, gender, ASA, and catecholamines) did not show notable association. Length of stay was mainly influenced by TSBA (+ 1.38 days per %, <jats:italic>p</jats:italic> &lt;  0.0001), age (+ 0.21 days per month, <jats:italic>p</jats:italic> = 0.0206), and administering of catecholamines (+ 14.3 days, <jats:italic>p</jats:italic> = 0.0118), but not by RBC transfusion. The decision to transfuse was in 23% too restrictive and in 74% too liberal according to the German guidelines.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Amount of TBSA, length of surgery, and Hb influenced the RBC transfusion rate in burned children. However, age and length of stay were not affected by transfusion of RBCs. In clinical practice of burned children, physicians follow a more liberal transfusion strategy than the proposed in guidelines.</jats:p> </jats:sec>
Autoren
  • Eva Wittenmeier
  • Astor Katharina
  • Irene Schmidtmann
  • Eva-Verena Griemert
  • Marc Kriege
  • Tatjana König
  • Pirlich Nina
DOI
10.1186/s12871-021-01336-3
eISSN
1471-2253
Ausgabe der Veröffentlichung
1
Zeitschrift
BMC Anesthesiology
Sprache
en
Artikelnummer
118
Online publication date
2021
Datum der Veröffentlichung
2021
Status
Published
Herausgeber
Springer Science and Business Media LLC
Herausgeber URL
http://dx.doi.org/10.1186/s12871-021-01336-3
Datum der Datenerfassung
2021
Titel
Intraoperative transfusion practice in burned children in a university hospital over four years: a retrospective analysis
Ausgabe der Zeitschrift
21

Data source: Crossref

Other metadata sources:
Author's licence
CC-BY
Autoren
  • Eva Wittenmeier
  • Katharina Astor
  • Irene Schmidtmann
  • Eva-Verena Griemert
  • Marc Kriege
  • Tatjana König
  • Nina Pirlich
Hosting institution
Universitätsbibliothek Mainz
Sammlungen
  • JGU-Publikationen
Resource version
Published version
DOI
10.1186/s12871-021-01336-3
File(s) embargoed
false
Open access
true
ISSN
1471-2253
Zeitschrift
BMC anesthesiology
Schlüsselwörter
  • 610 Medizin
  • 610 Medical sciences
Sprache
eng
Open access status
Open Access
Paginierung
118
Datum der Veröffentlichung
2021
Public URL
https://openscience.ub.uni-mainz.de/handle/20.500.12030/6993
Herausgeber
BioMed Central
Datum der Datenerfassung
2022
Datum, an dem der Datensatz öffentlich gemacht wurde
2022
Zugang
Public
Titel
Intraoperative transfusion practice in burned children in a university hospital over four years : a retrospective analysis
Ausgabe der Zeitschrift
21

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intraoperative_transfusion_pr-20220516123324417.pdf

Data source: OPENSCIENCE.UB

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