An Individualized Red Blood Cell Transfusion Strategy Using Pediatric Perioperative-Transfusion-Trigger Score Reduced Perioperative Blood Exposure for Children: A Randomized Controlled Clinical Trial.

IF 2.3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI:10.2147/TCRM.S388924
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Abstract

Objective: The optimal red blood cell transfusion strategy for children remains unclear. We developed an individualized red blood cell transfusion strategy for children and tested the hypothesis that transfusion guided by this strategy could reduce blood exposure, without increasing perioperative complications in children.

Methods: In this randomized controlled clinical trial, 99 children undergoing noncardiac surgeries who had blood loss of more than 20% total blood volume were randomly assigned to an individualized-strategy group using Pediatric Perioperative-Transfusion-Trigger Score or a control group. The amount of transfused red blood cell was counted, and patients were followed up for postoperative complications within 30 days.

Results: Twenty-six children (53.1%) in the individualized-strategy group received transfusion perioperatively, as compared with 37 children (74%) in the control group (p < 0.05). During surgery, children in the individualized-strategy group were exposed to fewer transfusions than in the control group (0.87±1.03 vs 1.33±1.20 Red-Blood-Cell units per patient, p = 0.02). The incidence of severe complications in the individualized-strategy group had a lower trend compared to the control group (8.2% vs 18%, p = 0.160). No significant difference was found in the other outcomes.

Conclusion: This trial proved that red blood cell transfusion guided by the individualized strategy reduced perioperative blood exposure in children, without increasing the incidence of severe complications. This conclusion needs to be reaffirmed by larger-scale, multicenter clinical trials.

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使用儿科围手术期输血触发评分降低儿童围手术期血液暴露的个体化红细胞输血策略:一项随机对照临床试验。
目的:儿童红细胞输注的最佳策略尚不清楚。我们为儿童开发了一种个性化的红细胞输血策略,并验证了这样一种假设,即在这种策略指导下输血可以减少血液暴露,而不会增加儿童围手术期并发症。方法:在这项随机对照临床试验中,99名接受非心脏手术的失血量超过总血容量20%的儿童被随机分配到使用儿科围手术期输血触发评分的个性化策略组或对照组。统计输注红细胞量,30 d内随访患者术后并发症情况。结果:个体化策略组围术期输血患儿26例(53.1%),对照组37例(74%)(p < 0.05)。手术期间,个体化策略组患儿输血量低于对照组(0.87±1.03 vs 1.33±1.20红细胞单位/例,p = 0.02)。与对照组相比,个体化治疗组的严重并发症发生率有较低的趋势(8.2% vs 18%, p = 0.160)。其他结果无显著差异。结论:本试验证明个体化策略指导下的红细胞输血可减少患儿围手术期血液暴露,且不增加严重并发症的发生率。这一结论需要通过更大规模的多中心临床试验来确认。
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.80
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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