《儿科重症监护输血和贫血专家倡议:危重儿童红细胞输注专家共识》介绍

An introduction to the Consensus Recommendations for RBC Transfusion Practice in Critically Ill Children from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative

贫血是危重症患儿常见表现,红细胞(red blood cell,RBC)输注是儿科重症监护病房(pediatric intensive care unit,PICU)常用治疗手段,在挽救患儿生命的同时,也带来输血相关性严重危害。为促进危重症患儿合理输注RBC,降低输血相关的严重危害,儿科重症监护输血和贫血专家倡议(transfusion and anemia expertise initiative,TAXI)专家组制订了危重症儿童RBC输注的专家共识。共识由12篇独立文章组成,包括共识推荐意见汇总1篇,涉及一般危重症、呼吸衰竭、非失血性休克、非危及生命的出血或失血性休克、急性脑损伤、获得性/先天性心脏病、血液系统和肿瘤性疾病、体外膜氧合/心室辅助装置/肾脏替代支持治疗共9类特殊人群的RBC输注的专家共识8篇,RBC的选择和处理、专家共识制订方法及共识应用的共识各1篇;包括102项推荐意见,其中57项为临床推荐意见(20项基于循证医学证据,37项基于专家共识),45项为对相关研究的推荐意见。该文仅介绍临床推荐意见。

Anemia is a common manifestation in critically ill children. The transfusion of red blood cell(RBC)is a commonly used treatment in the Pediatric Intensive Care Unit(PICU). While saving the lives of the children with critical illness,it also brings blood transfusion-related serious harm to the children. In order to promote reasonable RBC transfusion and reduce the serious hazards related to blood transfusion,Transfusion and Anemia Expertise Initiative(TAXI)panel work out the Consensus Recommendations for Red Blood Cell Transfusion Practice in Critically Ill Children. The consensus is composed of 12 independent articles:one of them is a summary of the consensus recommendations;eight of them deals with the recommendations on 9 specific subgroups respectively with general critical illness,respiratory failure,non-hemorrhagic shock,non-life-threatening hemorrhage or hemorrhagic shock,acute brain injury,acquired or congenital heart disease,hematologic and oncologic diseases,and those receiving extracorporeal membrane oxygenation/ventricular assist device renal replacement/support therapy;the other 3 are the choice and processing of RBC,the consensus recommendation methodology and the implementation of the recommendations respectively. There are 102 specific recommendations totally,of which 57 are clinical recommendations(20 evidence-based,37 expert consensus)and 45 are research recommendations. This article only introduces the clinical recommendations.