Transfusion of Leukocyte-Depleted RBCs Is Independently Associated With Increased Morbidity After Pediatric Cardiac Surgery

Martin C. J. Kneyber*, Femke Grotenhuis, Rolf F. M. Berger, Tjark W. Ebels, Johannes G. M. Burgerhof, Marcel J. I. J. Albers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objective: To test the hypothesis that transfusion of leukocyte-depleted RBC preparations within the first 48 hours of PICU stay was independently associated with prolonged duration of mechanical ventilation, irrespective of surgery type and disease severity.

Design: Retrospective, observational study.

Setting: Single-center PICU in The Netherlands.

Patients: Children less than 18 years consecutively admitted after pediatric cardiac surgery between February 2007 and February 2010.

Interventions: None.

Measurements and Main Results: Data from 335 patients were used for analysis of whom 86 (25.7%) were transfused during the first 48 hours of PICU stay. Duration of mechanical ventilation (115 +/- 19 hours vs. 25 +/- 4 hours, p <0.001) was longer among transfused patients. Ventilator-associated pneumonia (10.5% vs. 1.6%, odds ratio 7.2; 95% confidence interval 1.92-32.47; p <0.001) was more frequent among transfused patients. New acute kidney injury after 48 hours of PICU admission (23.9% vs. 15.4%, p = 0.18) and mortality were comparable (2.3% vs. 4%, p = 0.16). The number of discrete transfusion events was significantly correlated with the duration of mechanical ventilation (Spearman's rho 0.617, p <0.001). Transfusion remained independently associated with prolonged duration of mechanical ventilation after adjusting for confounders using Cox proportional hazards regression analysis.

Conclusions: Transfusion of leukocyte-depleted RBCs within the first 48 hours of PICU stay after cardiac surgery is independently associated with prolonged duration of mechanical ventilation. (Pediatr Crit Care Med 2013; 14:298-305)

Original languageEnglish
Pages (from-to)298-305
Number of pages8
JournalPediatric critical care medicine
Volume14
Issue number3
DOIs
Publication statusPublished - Mar-2013

Keywords

  • child
  • critical care
  • outcome
  • pediatric cardiac surgery
  • RBC transfusion
  • CRITICALLY-ILL CHILDREN
  • RED-BLOOD-CELLS
  • CARDIOPULMONARY BYPASS
  • NOSOCOMIAL INFECTIONS
  • RISK-FACTOR
  • MORTALITY
  • STRATEGIES
  • SCORE
  • TRIAL

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