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Pediatric transfusion

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https://www.readbyqxmd.com/read/29451224/hypogonadism-in-male-thalassemia-major-patients-pathophysiology-diagnosis-and-treatment
#1
Vincenzo De Sanctis, Ashraf T Soliman, Mohamed A Yassin, Salvatore Di Maio, Shahina Daar, Heba Elsedfy, Nada Soliman, Christos Kattamis
Failure of pubertal growth, delay or absence of sexual development, infertility and sexual dysfunction due to hypogonadism and defective spermatogenesis are frequent and well recognized disturbances among male patients with transfusion dependent (TD) thalassaemia major (β-thal). These problems are attributed mainly to the damage caused by chronic anaemia and the deposition of excess iron in the pituitary gland and testicles. This is a short review of male pubertal disorders in patients with β-thal written by pediatric endocrinologists and haematologists with an interest and active involvement, in the diagnosis and management of these complications in this group of patients...
February 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29448986/continuous-hemoglobin-monitoring-in-pediatric-trauma-patients-with-solid-organ-injury
#2
Emily Welker, Jennifer Novak, Lindsey Jelsma, Tracy Koehler, Alan Davis, James DeCou, Emily Durkin
BACKGROUND/PURPOSE: Hemoglobin monitoring is required in pediatric trauma patients with solid organ injury. We hypothesized that noninvasive hemodynamic monitoring (NIHM) represents an effective, safe alternative to laboratory hemoglobin (LabHb) monitoring in clinically stable patients. METHODS: A retrospective cohort study was conducted regarding pediatric trauma patients (<18 years old) with blunt solid organ injury over six consecutive months. Continuous NIHM was initiated at the time of admission, and LabHb measurements were obtained per institutional guidelines...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29443859/over-resuscitation-with-plasma-is-associated-with-sustained-fibrinolysis-shutdown-and-death-in-pediatric-traumatic-brain-injury
#3
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29435902/pediatric-living-donor-liver-transplantation-using-a-monosegment-procured-by-pure-3d-laparoscopic-left-lateral-sectionectomy-and-in-situ-reduction
#4
Suk Kyun Hong, Kyung-Suk Suh, Hyo-Sin Kim, Kyung Chul Yoon, Sung-Woo Ahn, Hyeyoung Kim, Nam-Joon Yi, Kwang-Woong Lee
BACKGROUND: Improvements in laparoscopic imaging systems and instruments have increased the performance of pure laparoscopic living donor hepatectomy. This operation is no longer limited to left lateral sectionectomy but is used for left hepatectomy and right hepatectomy.1-5 This report describes a donor who underwent pure laparoscopic left lateral sectionectomy and in situ reduction using 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography to obtain a monosegment...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29432302/allogeneic-matched-related-donor-bone-marrow-transplantation-for-pediatric-patients-with-severe-aplastic-anemia-using-low-dose-cyclophosphamide-atg-plus-fludarabine
#5
Chayamon Takpradit, Susan E Prockop, Nancy A Kernan, Andromachi Scaradavou, Kevin Curran, Julianne Ruggiero, Nicole Zakak, Richard J O'Reilly, Farid Boulad
BACKGROUND: The combination of cyclophosphamide (CY) and antithymocyte globulin (ATG) has been used as a standard conditioning regimen for matched related donor transplantation in patients with severe aplastic anemia. PROCEDURE: To decrease the regimen-related toxicity while maintaining appropriate engraftment and survival rates, fludarabine (FLU) was added to the regimen. Four pediatric patients received matched related donor bone marrow transplantation with CY (50 mg/kg×2) (instead of the 50 mg/kg×4 standard dosing), equine ATG (30 mg/kg×3), with the addition of FLU (30 mg/m×4)...
February 9, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29426688/variation-in-adolescent-idiopathic-scoliosis-surgery-implications-for-improving-healthcare-value
#6
Jennifer K Workman, Jacob Wilkes, Angela P Presson, Yizhe Xu, John A Heflin, John T Smith
OBJECTIVES: To investigate the variation in care and cost of spinal fusion for adolescent idiopathic scoliosis (AIS), and to identify opportunities for improving healthcare value. STUDY DESIGN: Retrospective cohort study from the Pediatric Health Information Systems database, including children 11-18 years of age with AIS who underwent spinal fusion surgery between 2004 and 2015. Multivariable regression was used to evaluate the relationships between hospital cost, patient outcomes, and resource use...
February 6, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29406799/management-of-pediatric-urolithiasis-using-a-combination-of-laparoscopic-lithotomy-and-pyeloscopy
#7
Sergio Landa-Juárez, Bárbara M Rivera-Pereira, Ana M Castillo-Fernández
BACKGROUND: Minimally invasive procedures have become the standard option for treatment of urinary stones; the use of more invasive techniques is not a common practice currently. This emergent technology is not always available and laparoscopy is the alternative option. There are few reports of laparoscopic management for urinary lithiasis in pediatric patients. This study is about the use of laparoscopic surgery combined with pyeloscopy as a feasible first-line treatment for pediatric urolithiasis in renal and proximal ureteral locations...
February 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29406374/cerebral-oxygen-metabolism-before-and-after-rbc-transfusion-in-infants-following-major-surgical-procedures
#8
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29399859/hyperleukocytosis-in-infant-acute-leukemia-a-role-for-manual-exchange-transfusion-for-leukoreduction
#9
Daniel V Runco, Cassandra D Josephson, Sunil S Raikar, Kelly C Goldsmith, Glen Lew, Melinda Pauly, Ross M Fasano
BACKGROUND: Hyperleukocytosis is a serious, life-threatening complication of pediatric acute leukemia that can cause neurologic injury, pulmonary leukostasis, metabolic derangements, and coagulopathy. Acute leukemia has the highest risk of mortality and morbidity at presentation when associated with hyperleukocytosis. Infant leukemia presents unique challenges and treatment considerations due to the disease itself and size and overall health of the patient. While medical management of hyperleukocytosis in older patients with acute leukemia has been described, including cytoreductive procedures with automated leukapheresis (AL) or manual whole blood (WB) exchange transfusion, very little data exist for standardized management of hyperleukocytosis in infant leukemia patients...
February 4, 2018: Transfusion
https://www.readbyqxmd.com/read/29399805/risks-of-red-blood-cell-alloimmunization-in-transfusion-dependent-%C3%AE-thalassemia-in-oman-a-25-year-experience-of-a-university-tertiary-care-reference-center-and-a-literature-review
#10
Arwa Z Al-Riyami, Ayman Al-Muqbali, Saif Al-Sudiri, Sathiya Murthi Panchatcharam, Mathew Zacharia, Sabah Al-Mahrooqi, Saif Al-Hosni, Ali Al-Marhoobi, Shahina Daar
BACKGROUND: β-Thalassemia is a common hemoglobinopathy in the Arabian Peninsula. Red blood cell (RBC) transfusion is a cornerstone for its management, but can create significant challenges including RBC alloimmunization. Herein, we examine alloimmunization risk factors in Omani patients with transfusion-dependent β-thalassemia. Existing literature is summarized. STUDY DESIGN AND METHODS: A retrospective review of all patients attending our center over 25 years was performed...
February 4, 2018: Transfusion
https://www.readbyqxmd.com/read/29395830/labile-plasma-iron-as-an-indicator-of-patient-adherence-to-iron-chelation-treatment
#11
Orna Steinberg-Shemer, Joanne Yacobovich, Miriam Cohen, Ioav Z Cabantchik, Hannah Tamary
Poor adherence of transfusion-dependent patients to chelation treatment is often the cause of persistent iron overload and ensuing morbidity. However, a tool to assess patient compliance with therapy is lacking in clinical practice. Labile plasma iron (LPI, the redox-active component of non-transferrin bound iron) has been studied as an indicator of systemic iron overload and of chelation efficacy, and may particularly reflect recent iron equilibrium. We considered the use of LPI as a potential indicator for recent chelation treatment in 18 transfusion-dependent pediatric patients...
January 23, 2018: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29391095/delta-shock-index-in-the-emergency-department-predicts-mortality-and-need-for-blood-transfusion-in-trauma-patients
#12
Morgan Schellenberg, Aaron Strumwasser, Daniel Grabo, Damon Clark, Kazuhide Matsushima, Kenji Inaba, Demetrios Demetriades
Shock Index (SI = heart rate/systolic blood pressure) predicts outcomes among trauma patients. Studies have also shown that the change in SI between the field and Emergency Department (ED) arrival (Delta SI) predicts mortality in trauma. Given the lack of reliable prehospital data, Delta SI may more accurately prognosticate if used within the ED. All trauma patients arriving to our Level I trauma center in 2014 were reviewed. Patients were matched for age, gender, mechanism of injury, and injury severity score...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29390566/clinical-features-and-outcomes-of-blunt-splenic-injury-in-children-a-retrospective-study-in-a-single-institution-in-china
#13
Kaiying Yang, Yanan Li, Chuan Wang, Bo Xiang, Siyuan Chen, Yi Ji
Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29389838/too-little-too-late-hypotension-and-blood-transfusion-in-the-trauma-bay-are-independent-predictors-of-death-in-injured-children
#14
Christine M Leeper, Christine McKenna, Barbara A Gaines
BACKGROUND: Hypotension is a late finding in pediatric shock despite significant blood loss; consequently, recognition of hemodynamic compromise can be delayed. We sought to describe the impact of late stage shock in children, indicated by hypotension or trauma bay blood transfusion, and quantify the association with poor outcome. METHODS: Children age<18 from the Pennsylvania Trauma Outcome Study registry (2000-2013) were included. Primary outcome was mortality...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29388216/transfusion-associated-circulatory-overload-in-a-pediatric-intensive-care-unit-different-incidences-with-different-diagnostic-criteria
#15
Lise De Cloedt, Guillaume Emeriaud, Émilie Lefebvre, Niina Kleiber, Nancy Robitaille, Christine Jarlot, Jacques Lacroix, France Gauvin
BACKGROUND: The incidence of transfusion-associated circulatory overload (TACO) is not well known in children, especially in pediatric intensive care unit (PICU) patients. STUDY DESIGN AND METHODS: All consecutive patients admitted over 1 year to the PICU of CHU Sainte-Justine were included after they received their first red blood cell transfusion. TACO was diagnosed using the criteria of the International Society of Blood Transfusion, with two different ways of defining abnormal values: 1) using normal pediatric values published in the Nelson Textbook of Pediatrics and 2) by using the patient as its own control and comparing pre- and posttransfusion values with either 10 or 20% difference threshold...
February 1, 2018: Transfusion
https://www.readbyqxmd.com/read/29384892/hemoglobin-levels-across-the-pediatric-critical-care-spectrum-a-point-prevalence-study
#16
Nabil E Hassan, Diann E Reischman, Robert K Fitzgerald, Edward Vincent S Faustino
OBJECTIVES: To determine the prevailing hemoglobin levels in PICU patients, and any potential correlates. DESIGN: Post hoc analysis of prospective multicenter observational data. SETTINGS: Fifty-nine PICUs in seven countries. PATIENTS: PICU patients on four specific days in 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients' hemoglobin and other clinical and institutional data...
January 30, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29383722/mechanisms-of-red-blood-cell-transfusion-related-immunomodulation
#17
REVIEW
Kenneth E Remy, Mark W Hall, Jill Cholette, Nicole P Juffermans, Kathleen Nicol, Allan Doctor, Neil Blumberg, Philip C Spinella, Philip J Norris, Mary K Dahmer, Jennifer A Muszynski
Red blood cell (RBC) transfusion is common in critically ill, postsurgical, and posttrauma patients in whom both systemic inflammation and immune suppression are associated with adverse outcomes. RBC products contain a multitude of immunomodulatory mediators that interact with and alter immune cell function. These interactions can lead to both proinflammatory and immunosuppressive effects. Defining clinical outcomes related to immunomodulatory effects of RBCs in transfused patients remains a challenge, likely due to complex interactions between individual blood product characteristics and patient-specific risk factors...
January 30, 2018: Transfusion
https://www.readbyqxmd.com/read/29368009/percutaneous-nephrolithotomy-versus-retrograde-intrarenal-surgery-for-pediatric-patients-with-upper-urinary-stones-a-systematic-review-and-meta-analysis
#18
REVIEW
Yiwen Chen, Tuo Deng, Xiaolu Duan, Wei Zhu, Guohua Zeng
The objective of this study is to compare the efficacy and safety of the percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in surgical treatment of pediatric patients with upper urinary stones based on the published literature. A comprehensive literature search of Pubmed, Embase, Cochrane Library and CNKI was conducted to identify studies comparing outcomes of PCNL and RIRS for treating pediatric patients with upper urinary stones before May 2017. A total of 11 studies, including one randomized controlled trial, four retrospective case-control studies and six case series studies, containing 822 children with upper urinary stones were included in this systematic review...
January 24, 2018: Urolithiasis
https://www.readbyqxmd.com/read/29356722/early-noninvasive-ventilation-and-nonroutine-transfusion-for-acute-chest-syndrome-in-sickle-cell-disease-in-children-a-descriptive-study
#19
Claire Heilbronner, Audrey Merckx, Valentine Brousse, Slimane Allali, Philippe Hubert, Mariane de Montalembert, Fabrice Lesage
OBJECTIVES: To describe the need for transfusion and short- and long-term evolutions of pediatric sickle cell disease patients with acute chest syndrome for whom early continuous noninvasive ventilation represented first-line treatment. DESIGN: Single-center retrospective chart study in PICU. SETTING: A tertiary and quaternary referral PICU. PATIENTS: All sickle cell disease patients 5-20 years old admitted with confirmed acute chest syndrome and not transfused in the previous month were included...
January 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29352663/early-versus-delayed-closure-of-bladder-exstrophy-a-national-surgical-quality-improvement-program-pediatric-analysis
#20
J J Ahn, M Shnorhavorian, C Katz, A B Goldin, P A Merguerian
INTRODUCTION: Delayed closure of bladder exstrophy has become more popular; however, there is limited the evidence of its success. Existing literature focuses on intermediate and long-term outcomes, and short-term postoperative outcomes are limited by the small number of cases and varying follow-up methods. OBJECTIVE: The objectives of the current study were to: 1) compare 30-day complications after early and delayed closure of bladder exstrophy, and 2) evaluate practice patterns of bladder exstrophy closure...
December 15, 2017: Journal of Pediatric Urology
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