Blood product use is audited for appropriateness of use. Hume et al developed a criteria map for determining if the use of red blood cell products is appropriate for a pediatric patient. The authors are from Hopital Ste-Justine and the Canadian Red Cross in Montreal.
NOTE: These criteria also appear applicable to adults.
|
Pretransfusion Hemoglobin |
Conditions |
Additional |
Interpretation |
|
>= 10 g/dL |
other reason to transfuse present |
|
depends on reason |
|
>= 10 g/dL |
no specific reason to transfuse |
|
inappropriate |
|
8 – 9.9 g/dL |
symptomatic or underyling disease |
|
appropriate |
|
8 – 9.9 g/dL |
emergency surgery |
|
uncertain |
|
8 – 9.9 g/dL |
treatable cause |
tried to treat without benefit |
uncertain |
|
8 – 9.9 g/dL |
treatable cause |
have not tried to treat |
inappropriate |
|
8 – 9.9 g/dL |
treatable cause |
positive response to therapy |
inappropriate |
|
8 – 9.9 g/dL |
no other treatment available |
|
uncertain |
|
8 – 9.9 g/dL |
etiology of anemia uncertain |
|
inappropriate |
|
< 8 g/dL |
symptomatic or underyling disease |
|
appropriate |
|
< 8 g/dL |
emergency surgery |
|
appropriate |
|
< 8 g/dL |
treatable cause |
tried therapy without benefit |
appropriate |
|
< 8 g/dL |
treatable cause |
have not tried to treat |
inappropriate |
|
< 8 g/dL |
treatable cause |
positive response to therapy |
depends on extent of response |
|
< 8 g/dL |
no other treatment available |
|
appropriate |
|
< 8 g/dL |
etiology of anemia unknown |
|
uncertain |
Symptoms indicating reduced oxygen carrying capacity in circulating blood:
(1) dyspnea
(2) tachycardia at rest (more than 2 SD above mean for age)
Underlying disease affected by oxygen carrying capacity of the blood:
(1) cardiac
(2) respiratory
(3) central nervous system
(4) neoplastic disease
Differences from criteria map:
(1) For hemoglobin < 8 g/dL and etiology unknown, the original interpretation is listed as inappropriate.
(2) Unknown etiology for anemia has been moved from the middle of flow diagram to the end of list.
(3) Handling treatable cause with response to therapy was not included in map.
(4) The criteria map has overlap at hemoglobin of 10 g/dL.
(5) I added neoplastic disease to the list of underlying diseases based on local practice.
Specialty: Clinical Laboratory
