Department of Pediatrics, Connecticut Children's Hospital, Hartford, Connecticut, USA.
Transfusion. 2010 Nov;50(11):2328-35. doi: 10.1111/j.1537-2995.2010.02708.x.
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 populations.
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.
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 10mg/dL. Fresh whole blood is available at 6 of 40 (15%) responding children's hospitals.
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.
之前的调查已经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新生儿和儿科普通人群的输血政策。
在 2008 年 10 月至 2009 年 1 月期间，调查了为儿童提供血液制品的美国和加拿大儿童医院的血液银行（BB）人员。
在确定的 90 家美国和加拿大儿童医院中，有 51 家（56.7%）血液银行家或其指定人员做出了回应。其中 42 家来自美国（82.4%），9 家来自加拿大（17.6%）。对于红细胞（RBC）储存年龄对结果的影响，66.6%的受访者有兴趣在危重症儿童中进行前瞻性随机试验，对此的看法存在很大差异。根据患者年龄和临床情况限制 RBC 储存年龄的政策也存在很大差异。在美国，33 名受访者中的 28 名（84.8%）提供 RBC 的普遍白细胞减少处理，而加拿大的 9 名（100%）提供该服务。RBC 辐照和洗涤的政策也存在差异。大多数受访者表示，如果输血前血红蛋白水平超过 8 至 10mg/dL，则会对 RBC 输血进行审核。在做出回应的 40 家儿童医院中，有 6 家（15%）可提供新鲜全血。
美国和加拿大儿童医院的 BB 政策在 RBC 输血方面存在很大差异。需要进行前瞻性随机对照试验，以便为 RBC 输血提供基于证据的护理标准。
