Feature Articles Survey on transfusion practices of pediatric intensivists*

Asignificant proportion of critically ill children receive red blood cell (RBC) transfusions during their pediatric intensive care unit (PICU) stay (15% in the PICU of Sainte-Justine Hospital) (1). There are few data on the indications for packed RBC transfusions in critically ill children, and therefore one may ask on what evidence pediatric intensivists base their transfusion decisions. The cost/efficacy of RBC transfusion is not clear: The risk of infection from an RBC transfusion is well recognized, but some data suggest also that transfusion may be a risk factor for nosocomial infection and multiple organ dysfunction syndrome (2). Moreover, a number of articles report that RBC transfusions are not optimally used (2). A survey reported a significant variation in transfusion practices among Canadian intensivists who take care of critically ill adults (3). The practice pattern that is advocated by pediatric intensivists with respect to RBC transfusion has not been studied. Thus, we undertook a survey among pediatric intensivists to find out their stated practice patterns in regard to RBC transfusion and to determine whether a consensus existed regarding the indications for RBC transfusion therapy.