2023
Bleeding in Critically Ill Children With Malignancy or Hematopoietic Cell Transplant: A Single-Center Prospective Cohort Study
Levasseur J, Fikse L, Mauguen A, Killinger J, Karam O, Nellis M. Bleeding in Critically Ill Children With Malignancy or Hematopoietic Cell Transplant: A Single-Center Prospective Cohort Study. Pediatric Critical Care Medicine 2023, 24: e602-e610. PMID: 37678406, PMCID: PMC10843653, DOI: 10.1097/pcc.0000000000003374.Peer-Reviewed Original ResearchConceptsProspective cohort studyBleeding episodesSevere bleedingIll childrenCohort studyCell transplantIncidence rateLaboratory valuesMinimal bleedingRadiation therapySingle-center prospective cohort studyAssociated Patient CharacteristicsHigher PICU mortalityNew bleeding episodesOnly laboratory valueHematopoietic cell transplantCritically Ill ChildrenLow platelet countSevere bleeding episodesStem cell transplantPatient demographic dataSpecialized cancer hospitalModerate bleeding episodesYears of ageLonger PICUThe Effects of Expectation Setting and Bundle Consent on Acute Caregiver Stress in the PICU: A Randomized Controlled Trial
Goldstein G, Karam O, Miller Ferguson N. The Effects of Expectation Setting and Bundle Consent on Acute Caregiver Stress in the PICU: A Randomized Controlled Trial. Pediatric Critical Care Medicine 2023, 24: 692-700. PMID: 37125809, DOI: 10.1097/pcc.0000000000003265.Peer-Reviewed Original ResearchConceptsBundled consentSeverity of illnessParents' perceptionsParents/guardians of patientsParents' perceived severityNegative mental health consequencesMental health consequencesPercentage of parentsCaregiver stressPersonal vulnerabilityChild's illnessChild's admissionControl groupChild's conditionExperimental groupPatients admitted to PICUDemographic surveyHealth consequencesLife-threatening natureStress burdenExpectation settingDemographic variablesControl weekIllnessAdmitted to PICUAnticoagulation and hemostasis on extracorporeal membrane oxygenation
Carmona C, Nellis M, Karam O. Anticoagulation and hemostasis on extracorporeal membrane oxygenation. Current Opinion In Pediatrics 2023, 35: 297-302. PMID: 36974451, DOI: 10.1097/mop.0000000000001247.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsChildExtracorporeal Membrane OxygenationHemorrhageHemostasisHemostaticsHumansProspective StudiesConceptsHemostatic transfusionsMembrane oxygenationPlatelet transfusionsProspective randomized trialsOptimal anticoagulation strategyExtracorporeal membrane oxygenationPlatelet transfusion strategyRecent systematic reviewHemostatic changesAnticoagulation strategiesFrequent complicationMost patientsThrombotic complicationsTransfusion strategyRandomized trialsCareful titrationObservational studyTransfusionSystematic reviewAnticoagulationECMOComplicationsBleedingTwo-fold decreaseRisk
2021
Compliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study*
Karsies T, Tarquinio K, Shein SL, Beardsley AL, Prentice E, Karam O, Fontela P, Moore-Clingenpeel M, Willson DF. Compliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study*. Pediatric Critical Care Medicine 2021, 22: 859-869. PMID: 33965989, DOI: 10.1097/pcc.0000000000002761.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsChildChild, PreschoolGuideline AdherenceHumansProspective StudiesRespiration, ArtificialUnited StatesVentilators, MechanicalConceptsVentilator-associated infectionPositive respiratory culturesRespiratory culturesAntibiotic continuationPhase 3 subjectsRespiratory culture resultsVentilator-Associated InfectionsObservational cohort studyOverall study populationBaseline data collectionPhase 1Antibiotic discontinuationAntibiotic recommendationsAntibiotic guidelinesAntibiotic decisionsCohort studyGuideline adherenceMicrobiologic dataIllness severityMechanical ventilationAntibiotic managementRespiratory secretionsAntibiotic utilizationConsensus guidelinesAntibiotic treatment
2020
Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children
Nellis ME, Spinella PC, Tucci M, Stanworth SJ, Steiner ME, Cushing MM, Davis PJ, Karam O, The Pediatric Acute Lung Injury and Sepsis Investigators network P. Effect of platelet storage duration on clinical outcomes and incremental platelet change in critically ill children. Transfusion 2020, 60: 2849-2858. PMID: 32959409, PMCID: PMC8396066, DOI: 10.1111/trf.16094.Peer-Reviewed Original ResearchConceptsClinical outcomesIll childrenPLT transfusionsObservational point prevalence studyPediatric intensive care unitStorage ageSafety of plateletsFurther prospective evaluationPoint prevalence studyIntensive care unitImmune system dysfunctionFebrile transfusion reactionsDays of ageScreening weekCare unitProspective evaluationSystem dysfunctionTransfusion reactionsPlatelet changesTransfusionPLT countTransfusion efficacyAge groupsSecondary analysisSignificant associationPreoperative erythropoietin within a patient blood management program decreases both blood transfusion and postoperative anemia: a prospective observational study
Biboulet P, Motais C, Pencole M, Karam O, Dangelser G, Smilevitch P, Maissiat G, Capdevila X, Bringuier S. Preoperative erythropoietin within a patient blood management program decreases both blood transfusion and postoperative anemia: a prospective observational study. Transfusion 2020, 60: 1732-1740. PMID: 32681743, DOI: 10.1111/trf.15900.Peer-Reviewed Original ResearchConceptsPatient blood management programBlood management programBlood transfusionPostoperative anemiaPreoperative erythropoietinObservational studyElective primary hipProspective observational studyMajor thromboembolicPreoperative hemoglobinCardiovascular eventsPreoperative treatmentTransfusion rateHospital dischargePostoperative infusionPostoperative periodIntraoperative administrationMajor complicationsTranexamic acidPrimary hipKnee arthroplastySingle hospitalTransfusionPatientsSpecific efficacyPediatric 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
Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity.
Nellis ME, Tucci M, Lacroix J, Spinella PC, Haque KD, Stock A, Steiner ME, Faustino EVS, Zantek ND, Davis PJ, Stanworth SJ, Cholette JM, Parker RI, Demaret P, Kneyber MCJ, Russell RT, Stricker PA, Vogel AM, Willems A, Josephson CD, Luban NLC, Loftis LL, Leteurtre S, Stocker CF, Goobie SM, Karam O. Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity. Critical Care Medicine 2019, 47: 1766-1772. PMID: 31567407, PMCID: PMC6861687, DOI: 10.1097/ccm.0000000000004025.Peer-Reviewed Original ResearchConceptsIll childrenAssessment ScaleDiagnostic criteriaProspective cohort studyRed cell transfusionCritically Ill ChildrenFuture epidemiologic studiesDelphi consensus processInternational expert consensusRounds of votingBleeding severityRelevant bleedingSubstantial inter-rater reliabilityBleeding episodesCell transfusionCohort studyCritical illnessOrgan dysfunctionOnline Delphi processSurgical interventionPediatric intensivistsPatient outcomesInter-rater reliabilityEpidemiologic studiesExpert consensusQuantifiable 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 testsAnemia at Discharge From the PICU: A Bicenter Descriptive Study.
Demaret P, Valla FV, Behal H, Mimouni Y, Baudelet JB, Karam O, Recher M, Duhamel A, Tucci M, Javouhey E, Leteurtre S. Anemia at Discharge From the PICU: A Bicenter Descriptive Study. Pediatric Critical Care Medicine 2019, 20: e400-e409. PMID: 31246740, DOI: 10.1097/pcc.0000000000002015.Peer-Reviewed Original ResearchConceptsPediatric critical illnessPICU admissionPICU dischargeRisk of anemiaCritical illnessRisk markersHigher C-reactive protein levelsInotropic/vasopressor supportC-reactive protein levelsWorld Health Organization criteriaMedian hemoglobin levelRetrospective cohort studyElectronic medical recordsVasopressor supportPlasma transfusionCohort studyCreatinine levelsMultivariate adjustmentAnemic childrenHemoglobin levelsMechanical ventilationAnemia statusOrganization criteriaMedical recordsIll childrenDevelopment of an Antibiotic Guideline for Children With Suspected Ventilator-Associated Infections.
Shein SL, Karam O, Beardsley A, Karsies T, Prentice E, Tarquinio KM, Willson DF. Development of an Antibiotic Guideline for Children With Suspected Ventilator-Associated Infections. Pediatric Critical Care Medicine 2019, 20: 697-706. PMID: 30985606, DOI: 10.1097/pcc.0000000000001942.Peer-Reviewed Original ResearchConceptsVentilator-associated infectionPhase 1 dataAntibiotic guidelinesGuideline scoreAntibiotic usePediatric Logistic Organ Dysfunction-2 scoreDuration of antibioticsPICU-free daysVentilator-Associated InfectionsVentilator-free daysInitiation of antibioticsProspective data collectionPhase 3Median ageMechanical ventilationVentilated childrenScore 3Consensus conferenceClinical testingScoring systemInfectionLiterature searchExpert panelAntibioticsScoresInternational 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.ProphylaxisAssessing our current practice: point prevalence studies in transfusion medicine
Nellis ME, Karam O. Assessing our current practice: point prevalence studies in transfusion medicine. Transfusion 2018, 58: 843-845. PMID: 29380394, DOI: 10.1111/trf.14492.Peer-Reviewed Original ResearchCorrelations between near-infrared spectroscopy, perfusion index, and cardiac outputs in extremely preterm infants in the first 72 h of life
Janaillac M, Beausoleil TP, Barrington KJ, Raboisson MJ, Karam O, Dehaes M, Lapointe A. Correlations between near-infrared spectroscopy, perfusion index, and cardiac outputs in extremely preterm infants in the first 72 h of life. European Journal Of Pediatrics 2018, 177: 541-550. PMID: 29374830, DOI: 10.1007/s00431-018-3096-z.Peer-Reviewed Original ResearchConceptsCerebral regional tissue oxygen saturationRight ventricular outputRegional tissue oxygen saturationTissue oxygen saturationLow cardiac output stateExtremely preterm infantsCardiac output statePreterm infantsCardiac outputPerfusion indexOxygen saturationVentricular outputSuperior vena cava flowLow SVC flowLeft ventricular outputMedian gestational ageWeeks of gestationVena cava flowNon-invasive toolHaemodynamic assessmentSVC flowTerm infantsBlood pressureCerebral oxygenationGestational age
2017
Outcomes Related to the Use of Frozen Plasma or Pooled Solvent/Detergent-Treated Plasma in Critically Ill Children*
Camazine MN, Karam O, Colvin R, Leteurtre S, Demaret P, Tucci M, Muszynski JA, Stanworth S, Spinella PC. Outcomes Related to the Use of Frozen Plasma or Pooled Solvent/Detergent-Treated Plasma in Critically Ill Children*. Pediatric Critical Care Medicine 2017, 18: e215-e223. PMID: 28350560, DOI: 10.1097/pcc.0000000000001149.Peer-Reviewed Original ResearchConceptsSolvent detergent plasmaPlasma 24 hoursICU mortalityIll childrenPlasma transfusionStudy groupHours groupPretransfusion international normalized ratioSolvent/detergent-treated plasmaCritically Ill ChildrenInternational normalized ratioHypothesis-generating dataMultivariable logistic regressionIllness scoresImproved survivalMedian ageAdjusted analysisNormalized ratioPrimary indicationIndependent associationFrozen plasmaObservational studyPlasma useLactate valuesPatients
2016
Ketosis After Cardiopulmonary Bypass in Children Is Associated With an Inadequate Balance Between Oxygen Transport and Consumption*
Klee P, Arni D, Saudan S, Schwitzgebel VM, Sharma R, Karam O, Rimensberger PC. Ketosis After Cardiopulmonary Bypass in Children Is Associated With an Inadequate Balance Between Oxygen Transport and Consumption*. Pediatric Critical Care Medicine 2016, 17: 852-859. PMID: 27472253, DOI: 10.1097/pcc.0000000000000880.Peer-Reviewed Original ResearchConceptsIndependent risk factorPICU admissionCardiopulmonary bypassInsulin treatmentCardiac surgeryRisk factorsPostoperative blood glucose levelsProspective observational studyPatients 6 monthsSubset of patientsSubgroup of patientsVenous oxygen saturationTight glycemic controlBlood glucose levelsGlycemic controlTertiary PICUGlucose intakeWorse outcomesPatient outcomesHigh prevalenceObservational studyGlucose levelsOxygen saturationMetabolic constellationAdmissionMassive Transfusion in Children
Karam O, Tucci M. Massive Transfusion in Children. Transfusion Medicine Reviews 2016, 30: 213-216. PMID: 27287298, DOI: 10.1016/j.tmrv.2016.05.010.Peer-Reviewed Original ResearchConceptsMassive transfusionTransfusion protocolTransfusion strategyPacked red blood cellsPediatric trauma patientsGoal-directed therapyWhole bloodMassive transfusion protocolHigh-quality evidenceCritical illnessRed blood cellsTransfusion supportAdjunctive treatmentTrauma patientsQuality evidenceClinical indicatorsTransfusionLaboratory testsBlood componentsBlood cellsFurther studiesAdditional investigationChildrenAdverse consequencesBlood
2015
Clinical Outcomes Associated With RBC Transfusions in Critically Ill Children
Demaret P, Tucci M, Karam O, Trottier H, Ducruet T, Lacroix J. Clinical Outcomes Associated With RBC Transfusions in Critically Ill Children. Pediatric Critical Care Medicine 2015, 16: 505-514. PMID: 25905491, DOI: 10.1097/pcc.0000000000000423.Peer-Reviewed Original ResearchMeSH KeywordsCase-Control StudiesChildChild, PreschoolCritical CareCritical IllnessErythrocyte TransfusionFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricLength of StayMaleMultiple Organ FailureOxygenPartial PressureProspective StudiesRenal Replacement TherapyRespiration, ArtificialTime FactorsTreatment OutcomeConceptsProgressive multiple organ dysfunction syndromeMultiple organ dysfunction syndromeFirst RBC transfusionOrgan dysfunction syndromeRBC transfusionIll childrenDysfunction syndromeRenal replacement therapyTertiary children's hospitalCritically Ill ChildrenProspective observational studyArterial partial pressurePICU lengthProlonged PICUPICU patientsMedical chartsClinical outcomesMechanical ventilationMultivariable analysisChildren's HospitalPotential confoundersReplacement therapyConsecutive admissionsPotential complicationsOdds ratio