Transfusion management of severe anaemia in African children: a consensus algorithm.
Br J Haematol
; 193(6): 1247-1259, 2021 06.
Article
en En
| MEDLINE
| ID: mdl-33955552
ABSTRACT
The phase III Transfusion and Treatment of severe anaemia in African Children Trial (TRACT) found that conservative management of uncomplicated severe anaemia [haemoglobin (Hb) 40-60 g/l] was safe, and that transfusion volume (20 vs. 30 ml/kg whole blood equivalent) for children with severe anaemia (Hb <60 g/l) had strong but opposing effects on mortality, depending on fever status (>37·5°C). In 2020 a stakeholder meeting of paediatric and blood transfusion groups from Africa reviewed the results and additional analyses. Among all 3196 children receiving an initial transfusion there was no evidence that nutritional status, presence of shock, malaria parasite burden or sickle cell disease status influenced outcomes or modified the interaction with fever status on volume required. Fever status at the time of ordering blood was a reliable determinant of volume required for optimal outcome. Elevated heart and respiratory rates normalised irrespective of transfusion volume and without diuretics. By consensus, a transfusion management algorithm was developed, incorporating three additional measurements of Hb post-admission, alongside clinical monitoring. The proposed algorithm should help clinicians safely implement findings from TRACT. Further research should assess its implementation in routine clinical practice.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Transfusión Sanguínea
/
Algoritmos
/
Consenso
/
Anemia de Células Falciformes
/
Malaria
Tipo de estudio:
Clinical_trials
/
Guideline
/
Prognostic_studies
Límite:
Child
/
Child, preschool
/
Humans
/
Male
País/Región como asunto:
Africa
Idioma:
En
Revista:
Br J Haematol
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido