Pediatric red blood cell transfusions increase resource use

Objective To test the hypothesis that red blood cell transfusions are associated with increased resource utilization and mortality in critically ill children. Methods Five pediatric intensive care units (PICUs) participated in a retrospective, cohort analysis (1996-1999). Children with a hemoglobin value less than or equal to 9 g/dL during their PICU stay were enrolled. Data consisted of descriptive information, hemoglobin values, use of blood products, PICU resource use, and hospital mortality rate. Results Among 240 children, 131 were transfused and 109 were not transfused. After controlling for the effects of other variables, transfusion was associated with an increase in days of oxygen use (4.48 +/- 1.37 days), days of mechanical ventilation (4.05 +/- 1.10 days), days of vasoactive agent infusions (1.27 +/- 0:44 days), and an increase of PICU and hospital lengths of stay (4.44 +/- 1.32, and 7.75 +/- 2.36 days, respectively). Conclusion Red blood cell transfusions are associated with an increase in resource utilization in critically ill children. The decision to transfuse patients should incorporate this potential morbidity.