• Martin C J Kneyber, Femke Grotenhuis, Rolf F M Berger, Tjark W Ebels, Johannes G M Burgerhof, and Marcel J I J Albers.
• Division of Paediatric Intensive Care, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands. m.c.j.kneyber@bkk.umcg.nl
• Pediatr Crit Care Me. 2013 Mar 1;14(3):298-305.

ObjectiveTo test the hypothesis that transfusion of leukocyte-depleted RBC preparations within the first 48 hours of PICU stay was independently associated with prolonged duration of mechanical ventilation, irrespective of surgery type and disease severity.DesignRetrospective, observational study.SettingSingle-center PICU in The Netherlands.PatientsChildren less than 18 years consecutively admitted after pediatric cardiac surgery between February 2007 and February 2010.InterventionsNone.Measurements And Main ResultsData from 335 patients were used for analysis of whom 86 (25.7%) were transfused during the first 48 hours of PICU stay. Duration of mechanical ventilation (115 ± 19 hours vs. 25 ± 4 hours, p < 0.001) was longer among transfused patients. Ventilator-associated pneumonia (10.5% vs. 1.6%, odds ratio 7.2; 95% confidence interval 1.92-32.47; p < 0.001) was more frequent among transfused patients. New acute kidney injury after 48 hours of PICU admission (23.9% vs. 15.4%, p = 0.18) and mortality were comparable (2.3% vs. 4%, p = 0.16). The number of discrete transfusion events was significantly correlated with the duration of mechanical ventilation (Spearman's rho 0.617, p < 0.001). Transfusion remained independently associated with prolonged duration of mechanical ventilation after adjusting for confounders using Cox proportional hazards regression analysis.ConclusionsTransfusion of leukocyte-depleted RBCs within the first 48 hours of PICU stay after cardiac surgery is independently associated with prolonged duration of mechanical ventilation.

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