Document Detail


Are red blood cell transfusions associated with nosocomial infections in pediatric intensive care units?
MedLine Citation:
PMID:  20081555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine whether red blood cell transfusion is similarly associated with nosocomial infections in pediatric intensive care unit patients and whether reduced lymphocyte numbers is a possible mechanism. In adult studies, red blood cell transfusions are associated with nosocomial infections.
DESIGN: Historical cohort study.
SETTING: Single-center, mixed medical-surgical, closed pediatric intensive care unit of a tertiary university-affiliated children's hospital.
PATIENTS: All patients < or = 18 yrs old admitted to the pediatric intensive care unit during a 6-month period from January 1 to July 3, 2005.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Nosocomial infections (respiratory, urinary tract, and bloodstream infections) were the primary outcome measure and were defined as post transfusion if occurring within 14 days after red blood cell transfusion. Of the 209 subjects enrolled, 32 (15%) acquired nosocomial infections and 45 (22%) received red blood cell transfusions. Patients with versus without nosocomial infections had received red blood cell transfusions significantly more often (odds ratio, 18.0; 95% confidence interval, 7.6-45.9; p < .001). In a dose-dependence analysis, we found that patients receiving > or = 3 red blood cell transfusions had a similar prevalence of nosocomial infections compared with those receiving one to two red blood cell transfusions (61% vs. 44%, p = .365), but greater mortality (22% vs. 0%, p = .04). In a multiple logistic regression analysis controlling for gender, age, pediatric intensive care unit length of stay, presence of an invasive catheter, mechanical ventilation, and surgery, red blood cell transfusion remained independently associated with risk of nosocomial infection (odds ratio, 3.73; 95% confidence interval, 1.19-11.85, p = .023). Transfused subjects had lower absolute lymphocyte counts compared with nontransfused subjects (1605 vs. 2054/microL, p = .041), but similar total white blood cell counts (10.4 vs. 11.4 x 10/microL, p = .52).
CONCLUSION: Red blood cell transfusion in pediatric intensive care unit patients is associated with an increased risk of nosocomial infections.
Authors:
Malik White; Joel Barron; Jeff Gornbein; James A Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  11     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-07     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  464-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Cohort Studies
Cross Infection / epidemiology*,  etiology
Erythrocyte Transfusion / adverse effects*
Female
Hospitals, Pediatric
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric*
Los Angeles / epidemiology
Male
Retrospective Studies
Risk
Young Adult
Comments/Corrections
Comment In:
Pediatr Crit Care Med. 2010 Jul;11(4):524-5   [PMID:  20606552 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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