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 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 ResearchConceptsHemostatic 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
2022
Anticoagulation strategies and recurrence of venous thromboembolic events in patients with sickle cell disease: a systematic review and meta-analysis
El-Amin N, Iness A, Cyrus JW, Sisler I, Karam O. Anticoagulation strategies and recurrence of venous thromboembolic events in patients with sickle cell disease: a systematic review and meta-analysis. Annals Of Hematology 2022, 101: 1931-1940. PMID: 35895101, DOI: 10.1007/s00277-022-04901-z.Peer-Reviewed Original ResearchMeSH KeywordsAnemia, Sickle CellAnticoagulantsHemorrhageHumansRecurrenceVenous ThromboembolismVenous ThrombosisConceptsVenous thromboembolic eventsSickle cell diseaseCell diseaseThromboembolic eventsPulmonary embolismSystematic reviewDevelopment of bleedingOverall bleeding rateVenous thrombotic eventsRisk of mortalityProgression of thrombusAnticoagulant classDifferent anticoagulationAnticoagulation strategiesOverall recurrenceOverall mortalityThrombotic eventsAdverse outcomesPatient populationBleeding rateObservational studyOutcome measuresAppropriate managementPatientsRecurrenceWhat Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative–Control/Avoidance of Bleeding
Delaney M, Karam O, Lieberman L, Steffen K, Muszynski JA, Goel R, Bateman ST, Parker RI, Nellis ME, Remy KE, Network A. What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically Ill Children and What Product Attributes Are Optimal to Guide Specific Product Selection? From the Transfusion and Anemia EXpertise Initiative–Control/Avoidance of Bleeding. Pediatric Critical Care Medicine 2022, 23: e1-e13. PMID: 34989701, PMCID: PMC8769352, DOI: 10.1097/pcc.0000000000002854.Peer-Reviewed Original ResearchConceptsAnemia EXpertise Initiative-Control/AvoidanceIll pediatric patientsIll childrenPlasma transfusionPediatric patientsPlatelet transfusionsConsensus statementSystematic reviewLos Angeles Appropriateness MethodPhysiologic triggerExpert-based statementsCritically Ill ChildrenDevelopment/UniversityExpert consensus statementCochrane Library databasesBleeding expertsRecommendations AssessmentTransfusion managementAppropriateness MethodBlood productsLaboratory testingTransfusionLibrary databasesConsensus conferenceExpert consensusPlasma and Platelet Transfusion Strategies in Critically Ill Children With Malignancy, Acute Liver Failure and/or Liver Transplantation, or Sepsis: From the Transfusion and Anemia EXpertise Initiative–Control/Avoidance of Bleeding
Lieberman L, Karam O, Stanworth SJ, Goobie SM, Crighton G, Goel R, Lacroix J, Nellis ME, Parker RI, Steffen K, Stricker P, Valentine SL, Steiner ME, Network A. Plasma and Platelet Transfusion Strategies in Critically Ill Children With Malignancy, Acute Liver Failure and/or Liver Transplantation, or Sepsis: From the Transfusion and Anemia EXpertise Initiative–Control/Avoidance of Bleeding. Pediatric Critical Care Medicine 2022, 23: e37-e49. PMID: 34989704, PMCID: PMC8769367, DOI: 10.1097/pcc.0000000000002857.Peer-Reviewed Original ResearchConceptsAnemia EXpertise Initiative-Control/AvoidanceAcute liver diseaseLiver transplantationExpert consensus statementLiver diseaseIntravascular coagulationIll neonatesPlatelet transfusionsIll childrenConsensus statementSystematic reviewLos Angeles Appropriateness MethodExpert-based statementsAcute liver failurePlatelet transfusion strategyDevelopment/UniversityCochrane Library databasesBleeding expertsRecommendations AssessmentTransfusion strategyLiver failureTransfusion managementAppropriateness MethodTransfusionSepsis
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 associationAnti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis
Willems A, Roeleveld PP, Labarinas S, Cyrus JW, Muszynski JA, Nellis ME, Karam O. Anti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis. Perfusion 2020, 36: 501-512. PMID: 32862767, PMCID: PMC8216320, DOI: 10.1177/0267659120952982.Peer-Reviewed Original ResearchConceptsAnticoagulation strategiesMortality rateThrombotic eventsObservational studySystematic reviewProportion of bleedingType of ECMOExtracorporeal membrane oxygenationMultiple electronic databasesLower mortality rateMembrane oxygenationPatientsElectronic databasesECMOThrombosisSignificant differencesXaBleedingReviewMortalityStudyEpidemiology 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
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 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 differencesBleeding Scales Applicable to Critically Ill Children: A Systematic Review.
Nellis ME, Levasseur J, Stribling J, Faustino EVS, Zantek ND, Sheth S, Karam O. Bleeding Scales Applicable to Critically Ill Children: A Systematic Review. Pediatric Critical Care Medicine 2019, 20: 603-607. PMID: 30925573, DOI: 10.1097/pcc.0000000000001943.Peer-Reviewed Original ResearchConceptsIll childrenIdiopathic thrombocytopenic purpuraFull-text articlesBleeding scoreBleeding scaleClinical outcomesIll patientsThrombocytopenic purpuraOvid EmbaseCochrane LibraryDatabase inceptionOvid MEDLINEElectronic searchUnique citationsSystematic reviewFinal reviewClinical measurementsOutpatientsInpatientsChildrenAdultsOutcomesBleedingPurpuraHemorrhageCriteria 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 locationBlood
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
Factors influencing plasma transfusion practices in paediatric intensive care units around the world
Karam O, Demaret P, Duhamel A, Shefler A, Spinella PC, Tucci M, Leteurtre S, Stanworth SJ, investigators T. Factors influencing plasma transfusion practices in paediatric intensive care units around the world. Vox Sanguinis 2017, 112: 140-149. PMID: 28176380, DOI: 10.1111/vox.12490.Peer-Reviewed Original ResearchConceptsPlasma transfusion practicesPlasma transfusionTransfusion practiceCoagulation testsPediatric intensive care unitInternational pediatric studiesLocal transfusion serviceAbnormal coagulation testsIntensive care unitEfficacy of transfusionSignificant relevant factorTransfusion policyTransfusion rateCare unitAppropriate indicationsPediatric studiesFrequent treatmentTransfusionResponse rateTransfusion servicesLocal investigatorsPatientsCenter characteristicsWide variationBleeding
2016
Massive 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
Indications and Effects of Plasma Transfusions in Critically Ill Children
Karam O, Demaret P, Shefler A, Leteurtre S, Spinella PC, Stanworth SJ, Tucci M. Indications and Effects of Plasma Transfusions in Critically Ill Children. American Journal Of Respiratory And Critical Care Medicine 2015, 191: 1395-1402. PMID: 25859890, DOI: 10.1164/rccm.201503-0450oc.Peer-Reviewed Original ResearchConceptsInternational normalized ratioMedian international normalized ratioPlasma transfusionIll childrenCoagulation testsBaseline international normalized ratioPediatric intensive care patientsPediatric intensive care unitPartial thromboplastin time valuesCritically Ill ChildrenPoint prevalence studyIntensive care patientsIntensive care unitStrong evidence baseMinor bleedingPostoperative bleedingMost patientsPatient characteristicsTransfusion strategyCare patientsCare unitCritical bleedingNormalized ratioPrimary indicationTransfusion