Transfusion management of severe anaemia in African children: a consensus algorithm.
African children
anaemia
guidelines
malaria
transfusion
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
06
01
2021
accepted:
18
02
2021
pubmed:
7
5
2021
medline:
28
9
2021
entrez:
6
5
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33955552
doi: 10.1111/bjh.17429
pmc: PMC7611319
mid: EMS130214
doi:
Types de publication
Clinical Trial, Phase III
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1247-1259Subventions
Organisme : Wellcome Trust
ID : 202800/Z/16/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00004/05
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/J012483/1
Pays : United Kingdom
Investigateurs
Bodo Bongomin
(B)
Eva Nabawanuka
(E)
Philippa Musoke
(P)
Ritah Nasiima
(R)
Hellen Mnjalla
(H)
Christabel Mogaka
(C)
Abubakarr Bah
(A)
Christian Umuhoza
(C)
William K A Obeng
(WKA)
Charlyne Kilba
(C)
John Appiah
(J)
Ismail Ticklay
(I)
Russel Ware
(R)
Roberta Petrucci
(R)
E T Mberi
(ET)
Claude T Tagny
(CT)
Saliou Diop
(S)
Faten Moftah
(F)
Michael E Acquah
(ME)
Philip Olatunji
(P)
Magdalena Lyimo
(M)
Ludovic Anani
(L)
Shirley O Ofori
(SO)
Charles Engoru
(C)
Informations de copyright
© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
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