Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
Part IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2 Toledano, and Nancy RobitailleAbstractAnemia is common in pediatric intensive care units (PICU). Severe anemia can significantly increase the risk of death. Only a red blood cell (RBCI transfusion can rapidly treat a severe anemia. In stable PICH patients. RBC transfusion is probably run required i Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2f the hemoglobin concentration is above 7 g/dL, unless the patient has a cyanotic cardiac condition, rhe trigger or goal that should be used to directEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
RBC transfusion therapy in unstable critically ill children remains undetermined, although some data suggest that RBC transfusion may help in the earPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2erfusions have been initiated. Plasma and platelets are used to prevent or to treat hemorrhage attributable to a coagulopathy, thrombocytopenia or platelet dysfunction. The risks and benefits of plasma and platelet concentrates in P1CU patients are discussed. There IS almost no evidence at the prese Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2nt lime that might permit a strong recommendation with regard to the use of plasma and platelets in PICƯ. Good knowledge of transfusion reactions is rEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
equired in order to appropriately estimate the cost/henefit ratio of transfusion. Nowadays, non-infectious serious hazards of transfusion (NISHOTI arePart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2on must be tailored to individual needs and repeated clinical evaluation of each critically ill child.KeywordsAnemia • Erythrocyte • Plasma • Platelets • TransfusionM.luixi. Ml)Lx.'panmcnt of Pediatrics. Saintc-Justinc Hospital.University of Montreal. 3175 Cote Sainte-CaUierine.Montreal. QC 11 VI IC Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2S. Canacbe-mail: marisa.tucei<ẽ'ícchcíclK-stc-justinc.qc.caJ. Lacroix. MD (EJ)Department of Pediatrics. Saillie Justine I lospilal3175 Cote Saintc-CatEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
bcrinc. Montreal, oc H3T IC5. Canadae-mail: jacqucsjacroixessss.gouv.qc.caE Gauvin. MD. FRCPC. MSc • B. Toledano. MD. FRCPC. MSc Division of PediatricPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2le, Ml). I RCPCDivision of I lematology-Oncology, Department of Pediatrics, Faeultd de Médceine. Saintc-Justine Hospital.Univeniilé de Montreal, Montreal, CanadaTransfusion of Red Blood CellsAnemia In the PICUAnemia—defined as a hemoglobin (Hb) concentration below the “normal” range for age has been Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2 reported to occur up to 74 % of critically ill children with a pediatric intensive care unit (PICU) stay longer than 2 days. Indeed, anemia is alreadEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
y present al the lime of PICU admission in 33 % of children, ami an additional 41 % develop anemia during their PICU stay [ 1 ]. Patients who become aPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2y. The main symptoms and signs of acute anemia areD.s. Wheeler Ct al. teds.t. Pediatric Critical Care Medicine.IM)I IO|OO7A)7S-1-447 IM 16-6 19, © Springer-Vcrlag London 2014259260M. Tucd et al.not specific and include pallor, tachycardia, lethargy and weakness. An increased blood lactate level and Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2elevated oxygen (O,» extraction ratio (>40 %) can also he observed in severe cases 12].The etiology of anemia may be attributable to: (1) blood loss.Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
(2) decreased bone marrow production, which may in part be secondary to a disturbed bone marrow response to erythropoietin |3). (3) decreased RBC survPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2of anemia acquired in the PICV. Blood draws account for 70 % of all blood loss (0.32 mUkg/day in PICU). and procedures and hemorrhage are other causes of blood loss (1 ].In healthy animals undergoing acute hemodilution, evidence of heart dysfunction appears only once the Hb concentration drops below Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2 3.3-4 g/dL 15.6]. However, animals with 50-80 % coronary artery stenosis can show evidence of ischemic insult to the heart with a Hb concentration asEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
high as 7-10 g/dL |7|. In human beings. Carson Ct al. [8| studied the outcome after surgery in 1.958 patients who declined transfusion for religious Part IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2elow 10 g/dL. Carson et al. |9| also studied the outcome after surgery in 300 patients without prior ischemic heart disease who declined transfusion for religious reasons. The odds ratio for death started to increase when the post-operative Hb concentration dropped below 4 g/dL. There are some data Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2describing the relationship between anemia in severely ill children and mortality. A prospective cohort study in Kenya of 1.269 hospitalized childrenEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
with malaria showed that RBC transfusions decreased death rate if anemia was severe (Hb level < 4 g/dL) or if some dyspnea was associated with a Hb lePart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2r acute anemia among which 20 % received RBC transfusions. Some benefit was observed when a RBC transfusion was given to patients with a Hb level below 4.7 g/dL. and if there were signs and symptoms of respiratory disease. Given these results, guidelines were written suggesting that a RBC transfusio Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2n should be given to all children with a Hb level < 5 g/dL hospitalized in this Kenyan hospital. Subsequently. Lackritz et al. 112) undertook a prospeEbook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2
ctive study in 1.223 consecutively hospitalized children. The Hb level was <5 g/dL in 303 patients. Of these patients. 116 (38 %) did not receive a trPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, Baruch Ebook Pediatric critical care medicine (Volume 3: Gastroenterological, endocrine, renal, hematologic, oncologic and immune systems - 2nd edition): Part 2ed with a Hb level > 5 g/dL: none of the latter children with a Hb level > 5 g/dL received aPart IVThe Hematologic System in Critical Illness and InjuryJacques LacroixTransfusion Medicine19Marisa Tucci, Jacques Lacroix, France Gauvin, BaruchGọi ngay
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