The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
Transfusion Strategies for Patients in Pediatric Intensive Care Units
Open accessAbstract
BACKGROUND: The optimal hemoglobin threshold for erythrocyte transfusions in critically ill children is unknown. We hypothesized that a restrictive transfusion strategy of using packed red cells that were leukocyte-reduced before storage would be as safe as a liberal transfusion strategy, as judged by the outcome of multiple-organ dysfunction. METHODS: In this noninferiority trial, we enrolled 637 stable, critically ill children who had hemoglobin concentrations below 9.5 g per deciliter within 7 days after admission to an intensive care unit. We randomly assigned 320 patients to a hemoglobin threshold of 7 g per deciliter for red-cell transfusion (restrictive-strategy group) and 317 patients to a threshold of 9.5 g per deciliter (liberal-strategy group). RESULTS: Hemoglobin concentrations were maintained at a mean (+/-SD) level that was 2.1+/-0.2 g per deciliter lower in the restrictive-strategy group than in the liberal-strategy group (lowest average levels, 8.7+/-0.4 and 10.8+/-0.5 g per deciliter, respectively; P<0.001). Patients in the restrictive-strategy group received 44% fewer transfusions; 174 patients (54%) in that group did not receive any transfusions, as compared with 7 patients (2%) in the liberal-strategy group (P<0.001). New or progressive multiple-organ dysfunction syndrome (the primary outcome) developed in 38 patients in the restrictive-strategy group, as compared with 39 in the liberal-strategy group (12% in both groups) (absolute risk reduction with the restrictive strategy, 0.4%; 95% confidence interval, -4.6 to 5.4). There were 14 deaths in each group within 28 days after randomization. No significant differences were found in other outcomes, including adverse events. CONCLUSIONS: In stable, critically ill children a hemoglobin threshold of 7 g per deciliter for red-cell transfusion can decrease transfusion requirements without increasing adverse outcomes. (Controlled-trials.com number, ISRCTN37246456 [controlled-trials.com].).
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Cites
Early goal-directed therapy in the treatment of severe sepsis and septic shock
Rivers, E., Nguyen, B., Havstad, S., Ressler, J., Muzzin, A., Knoblich, B., Peterson, E., & Tomlanovich, M. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010307 · Cited by 10,743
A Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care
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Self-citationA Multicenter, Randomized, Controlled Clinical Trial of Transfusion Requirements in Critical Care
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Pediatric risk of mortality (PRISM) score
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Self-citationSample size slippages in randomised trials: exclusions and the lost and wayward.
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Cited by
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock
Dellinger, R. P., Levy, M. M., Rhodes, A., Annane, D., Gerlach, H., Opal, S. M., Sevransky, J. E., Sprung, C. L., Douglas, I. S., Jaeschke, R., et al. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31827e83af · Cited by 9,694
Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion
Carson, J. L., Stanworth, S. J., Roubinian, N., Fergusson, D. A., Triulzi, D., Doree, C., & Hebert, P. C. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002042.pub4 · Cited by 1,250
Red Blood Cell Transfusion: A Clinical Practice Guideline From the AABB*
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Guidelines on transfusion for fetuses, neonates and older children
New, H. V., Berryman, J., Bolton‐Maggs, P. H. B., Cantwell, C., Chalmers, E. A., Davies, T., Gottstein, R., Kelleher, A., Kumar, S., Morley, S. L., et al. (2016) · British Journal of Haematology · doi:10.1111/bjh.14233 · Cited by 359
Transfusion thresholds for guiding red blood cell transfusion
Carson, J. L., Stanworth, S. J., Dennis, J. A., Trivella, M., Roubinian, N., Fergusson, D. A., Triulzi, D., Dorée, C., & Hébert, P. C. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002042.pub5 · Cited by 322
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Metadata
- Authors
- Lacroix, J., Hébert, P. C., Hutchison, J. S., Hume, H. A., Tucci, M., Ducruet, T., Gauvin, F., Collet, J.-P., Toledano, B. J., Robillard, P., Joffe, A., Biarent, D., Meert, K., & Peters, M. J.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-04-19
- Volume
- 356
- Issue
- 16
- Pages
- 1609-1619
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2156870897
- Cited by
- 1,085
- References
- 27
- FWCI
- 31.20
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Lacroix, J., Hébert, P. C., Hutchison, J. S., Hume, H. A., Tucci, M., Ducruet, T., Gauvin, F., Collet, J.-P., Toledano, B. J., Robillard, P., Joffe, A., Biarent, D., Meert, K., & Peters, M. J. (2007). Transfusion Strategies for Patients in Pediatric Intensive Care Units. New England Journal of Medicine. https://doi.org/10.1056/nejmoa066240
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