2024
Assessing the Reliability of the Bleeding Assessment Scale in Critically Ill Children (BASIC) Definition: A Prospective Cohort Study.
Nellis M, Chegondi M, Willems A, Alqatani M, McMichael A, Aran A, Lerner R, Karam O. Assessing the Reliability of the Bleeding Assessment Scale in Critically Ill Children (BASIC) Definition: A Prospective Cohort Study. Pediatric Critical Care Medicine 2024 PMID: 39560732, DOI: 10.1097/pcc.0000000000003638.Peer-Reviewed Original ResearchCritically ill childrenAssessment ScaleIll ChildrenBleeding severityIntra-rater reliabilityInter-rater reliabilityCohort of critically ill childrenChildren aged 0Prospective cohort studyAssociated with increased 28-day mortalityEvaluation of bleedingActivated partial thromboplastin timeBedside nursesPatient demographic dataPartial thromboplastin timeTransfused blood componentsLonger hospital lengthParticipating PICUsCohort studyHemostatic medicationsDiverse cohortInotropic supportBleeding eventsSevere bleedingPlatelet countClinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia.
Labarinas S, Norbisrath K, Johnson D, Meliones J, Greenleaf C, Salazar J, Karam O. Clinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia. Perfusion 2024, 2676591241247981. PMID: 38626382, DOI: 10.1177/02676591241247981.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationExtracorporeal membrane oxygenation daysCritically ill childrenSevere thrombocytopeniaPlatelet countPlatelet transfusionsMembrane oxygenationIll childrenMortality rateDuration of extracorporeal membrane oxygenationAssociated with in-hospital mortality ratesExtracorporeal membrane oxygenation durationSingle-center retrospective studyPlatelet transfusion strategyFrequent platelet transfusionsIn-hospital mortality rateAssociated with bleedingTransfusion strategyAssociated with higher proportionsMedian weightMulticenter studyRetrospective studyClinical outcomesOn-ECMOThrombocytopenia
2023
Scenario Decision-Making About Plasma and Platelet Transfusion for Intracranial Monitor Placement: Cross-Sectional Survey of Pediatric Intensivists and Neurosurgeons
Nellis M, Karam O, Aldave G, Rocque B, Bauer D, Network I. Scenario Decision-Making About Plasma and Platelet Transfusion for Intracranial Monitor Placement: Cross-Sectional Survey of Pediatric Intensivists and Neurosurgeons. Pediatric Critical Care Medicine 2023, 25: e205-e213. PMID: 37966339, PMCID: PMC10994730, DOI: 10.1097/pcc.0000000000003414.Peer-Reviewed Original ResearchTraumatic brain injuryInternational normalized ratioICP monitor placementPlatelet transfusionsPediatric intensivistsPlasma transfusionPediatric neurosurgeonsCase-based scenariosPlatelet countIntracranial pressurePediatric Acute Lung InjurySevere traumatic brain injury×109/LMonitor placementAcute lung injuryPlatelet count thresholdCross-sectional surveySepsis InvestigatorsLung injuryNormalized ratioTransfusion decisionsBrain injuryTransfusionIntensivistsViscoelastic testing
2022
Coagulation Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference.
Faustino EVS, Karam O, Parker RI, Hanson SJ, Brandão LR, Monagle P. Coagulation Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference. Pediatrics 2022, 149: s79-s83. PMID: 34970670, DOI: 10.1542/peds.2021-052888l.Peer-Reviewed Original ResearchConceptsCoagulation dysfunctionIll childrenCritical illnessStandard data extraction formOrgan-specific outcomesPediatric critical illnessPODIUM Consensus ConferenceD-dimer valuesInternational normalized ratioPatient-centered outcomesData extraction formOutcomes of interestLiver dysfunctionPlatelet countAdverse outcomesNormalized ratioFunctional statusEligible studiesFibrinogen levelsBias assessmentCoagulation testsCurrent evidenceConsensus conferenceElectronic searchTask force members
2021
Epidemiology of Bleeding in Critically Ill Children With an Underlying Oncologic Diagnosis
Romano J, Martinez M, Levasseur J, Killinger JS, Karam O, Nellis ME. Epidemiology of Bleeding in Critically Ill Children With an Underlying Oncologic Diagnosis. Critical Care Explorations 2021, 3: e0572. PMID: 34746797, PMCID: PMC8565795, DOI: 10.1097/cce.0000000000000572.Peer-Reviewed Original ResearchSevere bleedingOncologic diagnosisIll childrenEpidemiology of BleedingPICU-free daysSevere bleeding eventsVentilator-free daysIll pediatric patientsMedian platelet countRetrospective cohort studyInternational normalized ratioBlood component therapyVulnerable patient populationComprehensive cancer centerBleeding eventsHemostatic medicationsPICU admissionPercent patientsTransplant statusCohort studyMedian agePediatric patientsExact epidemiologySevere thrombocytopeniaPlatelet countTransfusion practices for pediatric oncology and hematopoietic stem cell transplantation patients: Data from the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III)
Goel R, Nellis ME, Karam O, Hanson SJ, Tormey CA, Patel RM, Birch R, Sachais BS, Sola‐Visner M, Hauser RG, Luban NLC, Gottschall J, Josephson CD, Hendrickson JE, Karafin MS, Study‐IV‐Pediatric F. Transfusion practices for pediatric oncology and hematopoietic stem cell transplantation patients: Data from the National Heart Lung and Blood Institute Recipient Epidemiology and Donor Evaluation Study‐III (REDS‐III). Transfusion 2021, 61: 2589-2600. PMID: 34455598, DOI: 10.1111/trf.16626.Peer-Reviewed Original ResearchConceptsInternational normalized ratioBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIINational Heart LungTransfusion practicePediatric oncologyRecipient EpidemiologyHSCT patientsPlasma transfusionRed blood cellsPlatelet countHeart LungHematopoietic stem cell transplantation patientsHematopoietic stem cell transplant patientsMedian international normalized ratioStem cell transplant patientsStem cell transplantation patientsLower INR valuesPre-transfusion HbMedian platelet countMulticenter retrospective studyCell transplant patientsCell transplantation patientsStudy IIIAcute myeloid leukemiaTransfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass: A Secondary Analysis of a Clinical Database
Hanson SJ, Karam O, Birch R, Goel R, Patel RM, Sola-Visner M, Sachais BS, Hauser RG, Luban NLC, Gottschall J, Josephson CD, Hendrickson JE, Karafin MS, Nellis ME, Lung A. Transfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass: A Secondary Analysis of a Clinical Database. Pediatric Critical Care Medicine 2021, 22: 978-987. PMID: 34261944, PMCID: PMC8570986, DOI: 10.1097/pcc.0000000000002805.Peer-Reviewed Original ResearchConceptsCongenital heart diseaseBiventricular surgeryCardiopulmonary bypass surgeryHeart diseaseMedian internationalBypass surgeryMembrane oxygenationPlatelet countBlood componentsVentricular surgeryHemoglobin valuesBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIIHigher median platelet countNormal international normalized ratioIntraoperative platelet transfusionLimited physiologic reserveMultiple blood productsPretransfusion platelet countU.S. hospitalsMedian platelet countBlood component transfusionBlood component usageExtracorporeal membrane oxygenationInternational normalized ratioVariation in Neonatal Transfusion Practice
Patel RM, Hendrickson JE, Nellis ME, Birch R, Goel R, Karam O, Karafin MS, Hanson SJ, Sachais BS, Hauser RG, Luban NLC, Gottschall J, Josephson CD, Sola-Visner M, National Heart L, Mast A, Hod E, Custer B, Vichinsky E, Spencer B, Mathew S, Harris D, Busch M, Norris P, Ness P, Kleinman S, Tamburro R, Glynn S, Malkin K. Variation in Neonatal Transfusion Practice. The Journal Of Pediatrics 2021, 235: 92-99.e4. PMID: 33836184, PMCID: PMC8316298, DOI: 10.1016/j.jpeds.2021.04.002.Peer-Reviewed Original ResearchConceptsWeeks of gestationEntire cohortPretransfusion hemoglobinPlatelet countNeonatal transfusionBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIIInternational normalized ratio (INR) valuesHematologic valuesNeonatal transfusion practicesPretransfusion platelet countRetrospective cohort studyBlood product transfusionGestational age groupsPatient blood managementNational Heart LungRecipient EpidemiologyInitial hospitalizationProduct transfusionCohort studyRed blood cellsGestational ageTransfusion practiceHeart LungBlood management
2020
Epidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation.
Karam O, Goel R, Dalton H, Nellis ME. Epidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation. Critical Care Medicine 2020, 48: e698-e705. PMID: 32697511, DOI: 10.1097/ccm.0000000000004417.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkChest tube outputMembrane oxygenationHemostatic transfusionsRBC transfusionTransfusion doseExtracorporeal membrane oxygenation daysLarge observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkTube outputPlatelet transfusion doseObservational cohort studyHuman Development Collaborative Pediatric Critical Care Research NetworkInternational normalized ratioTotal platelet countPartial thromboplastin timeAntithrombin levelsCohort studyConsecutive childrenTransfusion strategyChest tubePlatelet countHemostatic testingPediatric Plasma and Platelet Transfusions on Extracorporeal Membrane Oxygenation: A Subgroup Analysis of Two Large International Point-Prevalence Studies and the Role of Local Guidelines.
Nellis ME, Saini A, Spinella PC, Davis PJ, Steiner ME, Tucci M, Cushing M, Demaret P, Stanworth SJ, Leteurtre S, Karam O. Pediatric Plasma and Platelet Transfusions on Extracorporeal Membrane Oxygenation: A Subgroup Analysis of Two Large International Point-Prevalence Studies and the Role of Local Guidelines. Pediatric Critical Care Medicine 2020, 21: 267-275. PMID: 31644453, PMCID: PMC7060816, DOI: 10.1097/pcc.0000000000002160.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentBlood TransfusionChildChild, PreschoolExtracorporeal Membrane OxygenationFemaleHemorrhageHumansInfantInfant, NewbornIntensive Care Units, PediatricInternational Normalized RatioMalePlasmaPlatelet CountPlatelet TransfusionPractice Guidelines as TopicProspective StudiesSurveys and QuestionnairesConceptsExtracorporeal membrane oxygenationMembrane oxygenationPlatelet transfusionsTotal platelet countPlasma transfusionPlatelet countSubgroup analysisInstitutional protocolMedian increaseInternational point prevalence studyPediatric extracorporeal membrane oxygenationTotal median doseInternational normalized ratioML/Point prevalence studyPlatelet count valuesScreening weekMedian doseMild coagulopathyNormalized ratioInterventional studyLocal guidelinesObservational studyMedian reductionTransfusion
2019
Quantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome.
Nellis ME, Dalton H, Karam O. Quantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome. Critical Care Medicine 2019, 47: e886-e892. PMID: 31449061, PMCID: PMC8608374, DOI: 10.1097/ccm.0000000000003968.Peer-Reviewed Original ResearchConceptsChest tube bleedingExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkMembrane oxygenationChest tubeClinical outcomesPlatelet countML/Large observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkPICU-free daysPercent of patientsObservational cohort studyWorse clinical outcomesHuman Development Collaborative Pediatric Critical Care Research NetworkMembrane oxygenation specialistsHospital mortalityTransfusion volumeCohort studyHeparin doseConsecutive patientsThrombotic eventsPediatric institutionHemostatic testsInternational Study of the Epidemiology of Platelet Transfusions in Critically Ill Children With an Underlying Oncologic Diagnosis.
Nellis ME, Goel R, Karam O, Cushing MM, Davis PJ, Steiner ME, Tucci M, Stanworth SJ, Spinella PC. International Study of the Epidemiology of Platelet Transfusions in Critically Ill Children With an Underlying Oncologic Diagnosis. Pediatric Critical Care Medicine 2019, 20: e342-e351. PMID: 31107379, DOI: 10.1097/pcc.0000000000001987.Peer-Reviewed Original ResearchConceptsPlatelet transfusionsOncologic diagnosisIll childrenCurrent recommendationsHematopoietic stem cell transplantationCritically Ill ChildrenExtracorporeal life supportStem cell transplantationTotal platelet countMechanical ventilationPlatelet countAppropriate indicationsCell transplantationPediatric intensivistsSubgroup analysisObservational studyPlatelet functionTransfusionParent studyTherapeutic transfusionTotal plateletsLife supportDiagnosisVulnerable populationsSignificant differencesEffects of ABO Matching of Platelet Transfusions in Critically Ill Children*
Nellis ME, Goel R, Karam O, Cushing MM, Davis PJ, Steiner ME, Tucci M, Stanworth SJ, Spinella PC. Effects of ABO Matching of Platelet Transfusions in Critically Ill Children*. Pediatric Critical Care Medicine 2019, 20: e61-e69. PMID: 30422914, PMCID: PMC6709973, DOI: 10.1097/pcc.0000000000001779.Peer-Reviewed Original ResearchConceptsPlatelet transfusionsPlatelet countIll childrenTransfusion reactionsMinor incompatibilityCells/LABO-incompatible platelet transfusionsABO-compatible transfusionsABO-identical transfusionsABO-incompatible plateletsIncompatible platelet transfusionsCritically Ill ChildrenABO-identical plateletsABO-compatible plateletsMajor incompatibilityIncompatible plateletsNonbleeding patientsScreening weekPrimary outcomeSecondary outcomesABO matchingCompatible plateletsTransfusion doseMechanical ventilationOncologic diagnosis
2018
Platelet Transfusion Practices in Critically Ill Children
Nellis ME, Karam O, Mauer E, Cushing MM, Davis PJ, Steiner ME, Tucci M, Stanworth SJ, Spinella PC. Platelet Transfusion Practices in Critically Ill Children. Critical Care Medicine 2018, 46: 1309-1317. PMID: 29727368, PMCID: PMC6476545, DOI: 10.1097/ccm.0000000000003192.Peer-Reviewed Original ResearchConceptsPlatelet transfusionsCells/LMajor bleedingProphylactic transfusionICU mortalityMinor bleedingIll childrenOverall ICU mortalityPediatric critical illnessPlatelet transfusion practicesProspective cohort studyProphylactic platelet transfusionsCohort studyCritical illnessPost transfusionAdjusted analysisPlatelet countTransfusion practiceAppropriate indicationsMedian changePlatelet doseTransfusionBleedingCells/L.Prophylaxis
2017
Diagnosis and Management of Necrotizing Enterocolitis: An International Survey of Neonatologists and Pediatric Surgeons
Valpacos M, Arni D, Keir A, Aspirot A, Wilde JCH, Beasley S, De Luca D, Pfister RE, Karam O. Diagnosis and Management of Necrotizing Enterocolitis: An International Survey of Neonatologists and Pediatric Surgeons. Neonatology 2017, 113: 170-176. PMID: 29241163, DOI: 10.1159/000484197.Peer-Reviewed Original ResearchConceptsPediatric surgeonsBloody stoolManagement of NECPortal venous gasLow platelet countGut wall thicknessAbdominal tendernessGastric residualsAbdominal distensionVenous gasIntestinal pneumatosisNecrotizing enterocolitisSerious complicationsClinical featuresPlatelet countClinical examinationTreatment strategiesLactate levelsIntestinal movementNeonatologistsAntibiotic spectrumSurgeonsLimited evidenceNECEnterocolitis