Objectives: To determine the temporal relationship between the transfusion of RBCs and the subsequent development of delirium in a cohort of critically ill children. Design: Nested retrospective cohort study within prospective cohort study. Setting: Urban academic tertiary care PICU. Patients: All consecutive admissions from September 2014 through August 2015. Interventions: Children were screened twice daily for delirium during their PICU admission. Measurements and Main Results: Among 1,547 independent admissions screened for delirium, 166 (10.7%) were transfused RBCs. Children who were transfused RBCs were more than twice as likely to be delirious during their admission compared with children who were never transfused, after controlling for known predictors of delirium development (adjusted odds ratio, 2.16; 95% CI, 1.38–3.37; p = 0.001). Among transfused children, a temporal relationship was observed between receipt of RBCs and the subsequent development of delirium. For each additional 10 mL/kg of RBCs transfused, the recipients were 90% more likely to develop delirium or coma in the 72 hours following the transfusion, after controlling for confounders (adjusted odds ratio, 1.90; 95% CI, 1.14–3.17; p = 0.01). Anemia (represented by nadir hemoglobin prior to transfusion) was not associated with delirium development. Conclusions: In this cohort of critically ill children, there is an independent association between the receipt of an RBC transfusion and the subsequent development of delirium. Further prospective studies are warranted to replicate this finding and investigate possible pathophysiologic mechanisms for this association. Supported, in part, by the Empire Clinical Research Investigator Program and the Clinical Translational Science Center, grant number UL1-TR000457-06. Dr. Traube received support for article research from the National Institutes of Health. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: man9026@med.cornell.edu ©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2vio1rB
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
The name of the second author of this article was incorrectly presented as "Riccardo Scarpa Cosimo" this should have been "Co...
-
Abstract Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by au...
-
Abstract Introduction In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality fo...
-
Abstract Background Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation ...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the ch...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Tlj4K7
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου