6533b81ffe1ef96bd12788ab
RESEARCH PRODUCT
Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study.
Fuchs A.Disma N.Virag K.Ulmer F.Habre W.De Graaff J. C.Riva T.Nectarine Group Of The European Society Of Anaesthesiology And Intensive Care Clinical Trial Network: Christian BreschanRudolf LikarManuela PlatzerIsole EdelmanJohanes EgerStefan HeschlBrigitte MessererMaria VittinghofRuth KroessMartina StichlbergerDavid KahnThierry PirotteCaroline PregardienFrancis VeyckemansFrance StevensJohan BerghmansAnnemie BautersLuc De BaerdemaekerStefan De HertKoen LapageAliaksandra ParashchankaJurgen Van LimmenPiet WyffelsNadia NajafiJoris VundelinckxDiana ButkovićIvana Kerovec SorićSandra KralikAna MarkićJosip AzmanJosko MarkicDaniela PupacicMichal FrelichPetr ReimerRené UrbanecPetra CajkováVladimír MixaYvona SedláčkováLenka KnoppováAlena ZlámalováMartin VavřinaJiří ŽUrekTom HansenArash AfshariAnders Bastholm BilleMarguerite EllekvistMari-liis IlmojaReet MoorReet KikasMerle VäliKariantti KallioElisa ReponenPertti SuominenSami SuvantoRaisa VähätaloHannu KokkiMerja KokkiJarkko HarjuMiia KokkonenJenni VieriTuula MannerCatherine AmoryHugues LudotDina BertJuliette GodartAnne LaffargueHervé DupontBenjamin UrbinaCatherine BaujardPhilippe RoulleauGiuseppe StaitiMaryline BordesKarine Nouette GaulainYann HamonicFrançois SemjenOlivier JacqmarcqCaroline Lejus-bourdeauCécile MagneLéa PetryLilica RosAurélien ZangMehdi BennisBernard CoustetsRose FesseauIsabelle ConstantEliane KhalilNada SabourdinNoemie AudrenThomas DescarpentriesFanny FabreAurélien LegrandEmilie DruotGilles OrliaguetLucie SabauLynn UhrigFrançois De La BrièreKarin JonckheerJean-paul MissionLucia ScordoCaroline CouchepinChristophe DadurePablo De La ArenaLaurent HertzPhilippe PiratChrystelle SolaMyriam BellonSouhayl DahmaniFlorence Julien-marsollierDaphne MicheletVeronique Depret-donatienAnne LesageJost KaufmannMichael LaschatFrank WapplerKarin BeckeLena BrunnerKarin OppenriederGregor BadeltKarin HochmuthBernhard KollerAnita ReilSebastian RichterThomas FischerAnja DiersClemens SchorerAndreas WeylandRuth CohauszFranz-josef KretzMichaela LöfflerMarkus WilbsClaudia HoehneJohanna UlriciChristiane GoetersArmin FlinspachMatthias KlagesSimone LindauLeila MessroghliKai ZacharowskiChristoph EisnerThomas MuellerDaniel RichterMelanie SchäferMarkus WeigandSebastian WeitererMiriam OchsenreiterMichael SchölerTom TerbovenIsabel EggemannSascha HaussmannNicolas LeisterChristoph MenzelUwe TrieschmannSirin YücetepeSusanna KeiligPeter KrankeYvonne JeltingTorsten BaehnerRichard EllerkmannShahab GhamariClaudia NeumannMartin SöhlePelagia ChloropoulouVagia NtritsouPinelopi PapagiannopoulouEleana GariniAfroditi KarafotiaPanagoula MammiEvangelia BaliDespoina IordanidouAnna MalisiovaArtemis PolyzoiAdelais TsiotouErzsebet SapiEdgar SzékelyNandor KosikVeronika MarácziJanos SchnurJudit CsillagJános GálGergely GöblBalázs HauserAndrás PetróczyGyula TövisháziStuart BlainSarah GallagherSinead HarteMandy JacksonEmma MeehanZeenat NawoorBrendan O'hareMark RossDaniela LerroMarinella AstutoChiara GrassoRita ScalisiGiulia FrasaccoElena LenaresRoberto LeoneMaurizia GrazziniCarmelo MinardiNicola ZadraGilda CinnellaAntonella CotoiaDario GalanteBrita De LorenzoBeate KuppersGiulia BottazziFabio CaramelliMaria Cristina MondardiniEmanuele RossettiSergio PicardoAlessandro VittoriAnna CamporesiAndrea WolflerEdoardo CalderiniLaura Brigitta ColantonioSimona Anna FinamoreGiuliana Anna PorroRachele BonfiglioSvetlana KotzevaLeila MameliGirolamo MattioliCamilla MicalizziAlessia MontagutiAngela PistorioClelia ZanaboniAnna GuddoGerald Rogan NebaMoreno FavaratoBruno Guido LocatelliMicol MaffiolettiValter SonzogniRossella GarraMaria SammartinoFabio SbaragliaAndrea CortegianiAlessandra MoscarelliElena AttanasiSimonetta TesoroCristina AgapitiFrancesca PinzoniCesare VezzoliFederico BilottaArta BarzdinaZane StraumeAnda ZundaneLaura LukosieneIrena MaraulaiteIlona RazleviceBernd SchmitzStephanie MifsudCarolin AehlingCelia AllisonRients De BoerDina EmalMarkus StevensMarielle BuitenhuisInge De LiefdeAndreas MachottaGail ScoonesLonneke StaalsJeremy TomasAnouk Van Der Knijff-van DortmontMarianne VeldhuizenDavid AldersWolfgang BuhreEva SchafratJan SchreiberPetronella Mari VermeulenMark HendriksSandra LakoMarieke Voet-lindnerBarbe PietersGert-jan SchefferLuc TielensAnthony R AbsalomMargot BergsmaJoke De RuiterSascha MeierMartin VolkersTjerk ZweersAnne M BeukersChrista BoerJurgen DertingerSandra NumanBas Van ZaaneWenche B BoerkNil EkizKristoffer StensrudInger Marie DrageErik Ramon IsernAlicja Bartkowska-sniatkowskaMalgorzata GrzeskowiakMagdalena Juzwa-sobierajJowita Rosada-kurasińskaArtur BaranowskiKarina JakubowskaDorota LewandowskaMagdalena Mierzewska-schmidtPiotr SawickiMagdalena Urban-lechowiczPomianek PrzemyslawMarzena ZielinskaTeresa LealMaria SoaresPedro PinaSílvia PinhoMaria Domingas PatuleiaCatarina Cruz EstevesHelena SalgadoMaria João SantosRodica BadetiIulia CindeaLoredana OanaAdriana GuritaLuminita IlieGabriel MocioiuRadu TabacaruIrina TranteValentin MunteanuMihai MorariuEmese NyíriIvana BudicVesna MarjanovicBiljana DraškovićMarina PandurovJordanka IlicAna MandrasZdenka RadosNikola StankovicMaja SuicaSladjana VasiljevicMirjana KnezevicIrina MilojevicIvana PetrovSelena Puric RacicDusica SimicIrena SimicMarija StevicIrena VulicevicBarbora CabanováMiloslav HanulaJelena BergerDarja JanjatovicŠPela Pirtovšek ŠTupnikDolores MéndezGema PinoPaloma RubioAlberto IzquierdoSilvia LópezCristina González SerranoJesús CebriánAna PeleteiroPilar Del Rey De DiegoErnesto Martínez GarcíaCarolina Tormo De Las HerasPablo Troncoso MonteroCelia ArbonaDavid ArtésAlicia ChamizoSilvia SerranoMontserrat Suarez ComasFrancisco EscribáCristina AuliOsvaldo Pérez PardoNatalia Sierra BiddleCeferina Suárez CastañoMaría Isabel Villalobos RicoSusana Manrique MuñozIrene García MartínezNuria Montferrer EstruchElena Vilardell OrtízRodrigo Poves-álvarezIvan KohnUlf LindestamJarl ReinhardAlbert CastellheimKerstin SandströmSporre BengtRainer DörenbergPeter FrykholmMaria GarciaAnn KvarnströmEmma PonténThomas BruelisauerGabor ErdoesHeiko KaiserMathias MarchonStefan SeilerYann BögliMirko DolciCarine MarcucciIsabelle PichonLaszlo VutskitsMattias CasuttMartin HölzleThomas HurniMartin JöhrAnna-ursina MalärJacqueline MauchThomas ErbKarin OeinckMine AkinGulsen KeskinYesim SenayliGuner KayaPinar KendigelenAyse ÇIğdem TutuncuZehra HatipoğluDilek ÖZcengizHale Aksu ErdostElvan ÖçMenÇImen OlgunerHilmi AyanogluPelin Corman DincerTumay UmurogluMustafa AzizogluHandan BirbiçerNurcan DorukAslı SagunSibel BarisDmytro DmytriievSridevi KuchiNuria MasipPeter BrooksAlison HareNargis AhmadMichelle CaseySam De SilvaNadine DobbyPrakash KrishnanL Amaki SogbodjorEllie WalkerSuellen WalkerStephanie KingKaty NicholsonMichelle QuinneyPaul StevensAndrew BlevinMariangela GiombiniChulananda GoonasekeraSadia AdilStephanie BewCarol BodlaniDan GilpinStephanie JinksNalini MalarkkanAlice MiskovicRebecca PadJuliet Wolfe BarryJoy AbbottJames ArmstrongNatalie CooperLindsay CrateJohn EmeryKathryn JamesHannah KingPaul MartinStefano Scalia CatenacciRob BomontPaul SmithSara MeleAlessandra VerzelloniPhilippa DixGraham BellElena GordevaLesley MckeeEsther NganJutta ScheffczikLi-en TanMark WorrallCarmel CassarKevin GoddardVictoria BarlowVimmi OshanKhairi ShahSarah BellLisa DanielsMonica GandhiDavid PachterChris PerryAndrew RobertsonCarmen ScottLynne WaringDavid BarnesSophie ChildsJoanne NormanRobin Sunderlandsubject
Red Blood Cell TransfusionNEONATEHaemoglobin levels610 Medicine & healthPeri-operative ; red blood cell transfusion ; neonates ; infantsHigh morbidityHemoglobinsTRANSFUSIONmedicineClinical endpointHumansAnesthesiaProspective Studiesbusiness.industryPostmenstrual AgeInfant NewbornPerioperativeEuropeRed blood cellAnesthesiology and Pain Medicinemedicine.anatomical_structureAnesthesiaObservational studybusiness610 Medizin und GesundheitErythrocyte Transfusiondescription
BACKGROUND Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12���g���dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (���week 3) onwards. OBJECTIVE To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN A multicentre observational study. SETTING The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g���dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g���dl-1 in week 2 and 8.0 [7.3 to 9.0] g���dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml���kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g���dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02350348.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-03-01 | European journal of anaesthesiology |