G370(P) Trends in haemoglobin levels in children admitted to a paediatric intensive care unit

Abstract

Aims Children admitted to paediatric intensive care units (PICU) have a high prevalence of anaemia. Randomised controlled trial evidence has driven practice towards a restrictive strategy of blood transfusion within PICU. The aim of our study was to examine whether the effect of this led to a fall in haemoglobin (Hb) levels between PICU admission and hospital discharge. Methods We undertook a single-centre retrospective observational study over a 12 month period of children discharged from a general PICU to a ward within the same specialist children’s hospital. Data were collected at three time points – admission to PICU (T1), discharge from PICU (T2) and discharge from hospital (T3). Anaemia was defined as Hb Results Three-hundred and eighty-nine children were admitted to PICU and discharged to a ward within the hospital, with a median age of 14 months (inter-quartile range 1–70 months). Overall, 224/389 (57.6%) children had anaemia at T1, compared to 255/389 (65.6%) at T2 and 236/389 (60.7%) at T3. The mean Hb level was 111.9 g/L (range 29–211 g/L) at T1, 105.5 g/L (range 51–223 g/L) at T2 and 105.6 g/L (range 51–198 g/L) at T3. The Hb distribution was significantly different between the time-points following repeated measures ANOVA (p-value=0.0008). Hb decreased significantly between T1 and T2 (p-value Conclusion Anaemia is common in PICU. Hb falls between PICU admission and hospital discharge. Further study is needed to determine whether haemoglobin levels recover over time with/without treatment, and the impact this has on longer term health outcomes.