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 PICUFirst nosocomial infections in children supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO)
Cousin V, Rodriguez-Vigouroux R, Karam O, Rimensberger P, Posfay-Barbe K. First nosocomial infections in children supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). BMC Pediatrics 2023, 23: 89. PMID: 36823601, PMCID: PMC9948414, DOI: 10.1186/s12887-023-03908-3.Peer-Reviewed Original ResearchConceptsVA-ECMO supportPediatric intensive care unitMedian timeClinical signsMedian PICU LOSNosocomial infection occurrenceUrinary tract infectionVentilator-associated pneumoniaExtracorporeal membrane oxygenationIntensive care unitPaucity of dataPICU lengthPICU LOSRefractory shockVA-ECMOTract infectionsMedian ageMembrane oxygenationSternotomy infectionsCare unitRetrospective studySevere infectionsFirst infectionMortality rateInfection occurrence
2021
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)
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 a large cohort of hospitalized children
Nellis ME, Goel R, Hendrickson JE, Birch R, Patel RM, Karafin MS, Hanson SJ, Sachais BS, Hauser RG, Luban NLC, Gottschall J, Sola‐Visner M, Josephson CD, Karam O, Study‐IV‐Pediatric F. Transfusion practices in a large cohort of hospitalized children. Transfusion 2021, 61: 2042-2053. PMID: 33973660, DOI: 10.1111/trf.16443.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentBlood Component TransfusionBlood TransfusionChildChild, PreschoolDatasets as TopicDiagnosis-Related GroupsFemaleHospital MortalityHospitals, CommunityHospitals, TeachingHumansInfantInfant, NewbornInpatientsMaleProcedures and Techniques UtilizationRetrospective StudiesUnited StatesConceptsRBC transfusionCardiopulmonary bypassTransfusion practiceHospitalized childrenInpatient encountersBlood componentsLarge cohortHospital settingBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIIPatient blood management initiativesDiagnostic categoriesFrequency of transfusionInstitutional transfusion guidelinesCohort of patientsInternational normalized ratioPercent of encountersNational Heart LungPediatric hospital settingYears of ageSubset of childrenRecipient EpidemiologyTransfusion guidelinesRed blood cellsEntire cohortVariation 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
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 efficacyIndividual‐ and hospital‐level correlates of red blood cell, platelet, and plasma transfusions among hospitalized children and neonates: a nationally representative study in the United States
Goel R, Josephson CD, Patel EU, Petersen MR, Packman Z, Gehrie E, Bloch EM, Lokhandwala P, Ness PM, Katz L, Nellis M, Karam O, Tobian AAR. Individual‐ and hospital‐level correlates of red blood cell, platelet, and plasma transfusions among hospitalized children and neonates: a nationally representative study in the United States. Transfusion 2020, 60: 1700-1712. PMID: 32589286, PMCID: PMC7951993, DOI: 10.1111/trf.15855.Peer-Reviewed Original ResearchConceptsAdjusted odds ratioRed blood cellsRBC transfusionPlatelet transfusionsPlasma transfusionAge groupsBlood cellsElective admission statusProportion of neonatesMultivariable logistic regressionOlder age groupsTotal hospitalizationsPrimary outcomeSecondary outcomesHospitalized neonatesNonwhite raceHospitalized childrenFemale sexOverall prevalenceOdds ratioHospital birthsPediatric dischargesTransfusion proceduresTransfusionHigh riskEpidemiology 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 testingPleural Effusions After Congenital Cardiac Surgery Requiring Readmission: A Systematic Review and Meta-analysis
Hughes A, Carter K, Cyrus J, Karam O. Pleural Effusions After Congenital Cardiac Surgery Requiring Readmission: A Systematic Review and Meta-analysis. Pediatric Cardiology 2020, 41: 1145-1152. PMID: 32424719, DOI: 10.1007/s00246-020-02365-4.Peer-Reviewed Original ResearchConceptsCongenital heart diseaseSingle-ventricle palliationPleural effusionRisk factorsPost-pericardiotomy syndromeImproved risk stratificationSingle ventricle physiologySubpopulation of patientsAdditional invasive proceduresRandom-effects modelFull-text articlesBiventricular physiologyHospital dischargeSurgical patientsCardiopulmonary bypassRisk stratificationPatient populationEarly recognitionHeart diseaseOverall prevalenceSurgical techniqueFallot patientsInvasive proceduresReadmissionPatientsPediatric 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 differencesCriteria for Clinically Relevant Bleeding in Critically Ill Children
Karam O, Nellis ME, Zantek ND, Lacroix J, Faustino EVS. Criteria for Clinically Relevant Bleeding in Critically Ill Children. Pediatric Critical Care Medicine 2019, Publish Ahead of Print: &na;. PMID: 30575698, DOI: 10.1097/pcc.0000000000001828.Peer-Reviewed Original ResearchConceptsRelevant bleedingStreaks of bloodIll childrenEndotracheal tubeClinical relevancePediatric critical care physiciansClinically Relevant BleedingML/Critical care physiciansCritical illnessIll adultsOrgan failureCare physiciansGastric tubeClinical significanceNurse practitionersBleedingDiagnostic criteriaClinical practiceResponse rateIntensivists' perceptionWeb-based surveyDiagnostic definitionRespondents' geographical locationBloodEffects 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
International, multicentre, observational study of fluid bolus therapy in neonates
Keir AK, Karam O, Hodyl N, Stark MJ, Liley HG, Shah PS, Stanworth SJ, Group O. International, multicentre, observational study of fluid bolus therapy in neonates. Journal Of Paediatrics And Child Health 2018, 55: 632-639. PMID: 30328174, DOI: 10.1111/jpc.14260.Peer-Reviewed Original ResearchConceptsFluid bolus therapyBolus therapyNeonatal unitHaemodynamic compromiseObservational studyFluid bolus administrationMulticentre observational studyRisk-benefit profilePooled prevalence rateWide international variationDays of ageClinical improvementFrequent indicationAppropriate indicationsFluid bolusMetabolic acidosisPoor perfusionPatient daysBolus administrationPrevalence ratesStudy daysNeonatesStudy periodTherapyRelevant studiesPlatelet 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