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Critical Care Research and Practice
Volume 2012, Article ID 646473, 6 pages
http://dx.doi.org/10.1155/2012/646473
Research Article

Respiratory Impairment after Early Red Cell Transfusion in Pediatric Patients with ALI/ARDS

1Division of Pediatric Critical Care Medicine, Helen DeVos Children’s Hospital, 100 Michigan Street NE, Grand Rapids, MI 49503, USA
2Research Department, Grand Rapids Medical Education Partners, 1000 Monroe NW, Grand Rapids, MI 49503, USA

Received 14 May 2012; Accepted 13 July 2012

Academic Editor: Djillali Annane

Copyright © 2012 Surender Rajasekaran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. In the first 48 hours of ventilating patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), a multipronged approach including packed red blood cell (PRBC) transfusion is undertaken to maintain oxygen delivery. Hypothesis. We hypothesized children with ALI/ARDS transfused within 48 hours of initiating mechanical ventilation would have worse outcome. The course of 34 transfused patients was retrospectively compared to 45 nontransfused control patients admitted to the PICU at Helen DeVos Children’s Hospital between January 1st 2008 and December 31st 2009. Results. Mean hemoglobin (Hb) prior to transfusion was 8.2 g/dl compared to 10.1 g/dl in control. P/F ratio decreased from 1 3 5 . 4 ± 7 . 5 to 1 1 6 . 5 ± 8 . 8 in transfused but increased from 1 4 8 . 0 ± 8 . 0 to 1 9 0 . 4 ± 1 7 . 8 ( 𝑃 < 0 . 0 0 1 ) in control. OI increased in the transfused from 1 1 . 7 ± 0 . 9 to 1 8 . 7 ± 1 . 6 but not in control. Ventilator days in the transfused were 1 5 . 6 ± 1 . 7 versus 9 . 5 ± 0 . 6 days in control ( 𝑃 < 0 . 0 0 1 ). There was a trend towards higher rates of MODS in transfused patients; 29.4% versus 17.7%, odds ratio 1.92, 95% CI; 0.6–5.6 Fisher exact 𝑃 < 0 . 2 8 2 . Conclusion. This study suggests that early transfusions of patients with ALI/ARDS were associated with increased ventilatory needs.