P0086 / #419: EPIDEMIOLOGY OF RED BLOOD CELL TRANSFUSIONS IN A PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: to determine the prevalence of red blood cell (RBC) transfusions in a PICU. To describe the profile and evolution of the transfused population in comparison with those not transfused during their PICU stay. Methods: retrospective, observational study. We included all patients aged 1 -216 month, admitted to the medical/surgical PICU of a Public University Hospital between 4-1-2017 and 3-31-2018. We performed descriptive statistics; simple and multivariate logistic and linear regression models for the statistical analysis. Results: 294 admissions were registered during the study period. The prevalence of RBC transfusion was 42.8% (95% CI 37-48%). The RBC transfusion was associated with younger age [(21 months (IQR 7-84) in children transfused vs 69.5 (66-113) in those no transfused, p: 0.03;] higher mortality risk predicted by PIM2 [9.3 (SD 13.9) vs 5.64 (SD 12.5), p <0.001] and admission diagnosis of leukemia or sepsis [OR 3 (95% CI 1.14-9.25) and 4.8 (2.53-9.4) respectively]. The mean pretransfusional hemoglobin value (PHb) was 7.75 gr / dl (SD 1.2). There was no statistically significant difference in its value according to admission diagnosis, presence of complex chronic condition, solid tumors or leukemia. The RBC transfusion was associated with higher PICU mortality (OR 11.87; 95% CI 3.8-37.5), length of stay in PICU and length of mechanical ventilation, adjusted by confounding factors. Conclusions: The prevalence of RBC transfusion and the value of PHb is higher than suggested by international guidelines. It is necessary to optimize the resource use in the PICU.