2024
Clinical 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 testingAnticoagulation 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
Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A Systematic Review and Meta-Analysis
Schertz K, Karam O, Demetres M, Mayadunna S, Faraoni D, Nellis ME. Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A Systematic Review and Meta-Analysis. Pediatric Critical Care Medicine 2022, 23: e517-e529. PMID: 35997516, DOI: 10.1097/pcc.0000000000003049.Peer-Reviewed Original ResearchConceptsChest tube outputQuality of evidenceCardiopulmonary bypassTranexamic acidCardiac surgeryMean decreaseTube outputPlatelet requirementsPlatelet transfusionsML/P-valueMeta-AnalysisSystematic reviewStandardized data extraction toolBlood product requirementsPediatric cardiac surgeryPlasma requirementsPreferred Reporting ItemsData extraction toolWeb of SciencePostoperative bleedingCyanotic patientsPlasma transfusionBlood lossRBC transfusionEffect of Platelet Transfusions on Extracorporeal Life Support Oxygenator’s Function
Chegondi M, Vijayakumar N, Badheka A, Karam O. Effect of Platelet Transfusions on Extracorporeal Life Support Oxygenator’s Function. Frontiers In Pediatrics 2022, 10: 826477. PMID: 35321010, PMCID: PMC8936087, DOI: 10.3389/fped.2022.826477.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationPediatric intensive care unitPlatelet transfusionsOxygenator functionECMO supportVeno-arterial extracorporeal membrane oxygenationOnly independent factorSubgroup of patientsIntensive care unitAnticoagulation strategiesCommon complicationMembrane oxygenationCare unitRetrospective studyMain complicationsLowest quartileTransfusionIndependent factorsMmHgECMO oxygenatorROC curveComplicationsPatientsChildrenRegression modelsWhat 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 MethodTransfusionSepsisExecutive Summary of Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative—Control/Avoidance of Bleeding (TAXI-CAB)
Nellis ME, Karam O, Valentine SL, Bateman ST, Remy KE, Lacroix J, Cholette JM, Bembea MM, Russell RT, Steiner ME, Goobie SM, Tucci M, Stricker PA, Stanworth SJ, Delaney M, Lieberman L, Muszynski JA, Bauer DF, Steffen K, Nishijima D, Ibla J, Emani S, Vogel AM, Haas T, Goel R, Crighton G, Delgado D, Demetres M, Parker RI, Network A. Executive Summary of Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative—Control/Avoidance of Bleeding (TAXI-CAB). Pediatric Critical Care Medicine 2022, 23: 34-51. PMID: 34989711, PMCID: PMC8820267, DOI: 10.1097/pcc.0000000000002851.Peer-Reviewed Original ResearchConceptsIll pediatric patientsPlatelet transfusionsPediatric patientsIll childrenAnemia EXpertise Initiative-Control/AvoidanceSystematic reviewExpert-based consensusMultidisciplinary international expertsPlatelet transfusion practicesGrading of RecommendationsRisk of bleedingAdministration of plasmaConsensus-based statementsCochrane Library databasesEvidence-based recommendationsBest practice statementsClinical decision treeSubject Headings termsCritical illnessIll infantsTransfusion practicePediatric intensivistsConsensus statementTransfusionLibrary databases
2020
Overview of Plasma and Platelet Transfusions in Critically Ill Children
Kahn S, Chegondi M, Nellis ME, Karam O. Overview of Plasma and Platelet Transfusions in Critically Ill Children. Frontiers In Pediatrics 2020, 8: 601659. PMID: 33282804, PMCID: PMC7691248, DOI: 10.3389/fped.2020.601659.Peer-Reviewed Original ResearchIndividual‐ 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 riskPediatric 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
International 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