• Caroline Laverdière, France Gauvin, Paul C Hébert, Claire Infante-Rivard, Heather Hume, Baruch J Toledano, Marie-Claude Guertin, Jacques Lacroix, and Canadian Critical Care Trials Group.
• Hematology Division, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Québec, Canada.
• Pediatr Crit Care Me. 2002 Oct 1;3(4):335-40.

ObjectiveTo describe the red blood cell transfusion practices of pediatric intensivists.DesignCross-sectional self-administered survey.SettingPediatric intensive care units.PatientsAcademic pediatric intensivists.InterventionsNone.Measurements And ResultsScenario-based survey among English- or French-speaking intensivists from Canada, France, Belgium, or Switzerland, working in tertiary-care pediatric intensive care units. Respondents were asked to report their decisions regarding transfusion practice with respect to four scenarios: cases of bronchiolitis, septic shock, trauma, and the postoperative care of a patient with Fallot's tetrad. The response rate was 71% (163 of 230). The overall baseline hemoglobin transfusion threshold that would have prompted intensivists to transfuse a patient ranged from 7 to 13 g/dL (70-130 g/L) within almost all scenarios. There was a significant difference between scenarios of the average baseline hemoglobin transfusion thresholds (p < .0001). A low Pao2, a high blood lactate concentration, a high Pediatric Risk of Mortality score, active gastric bleeding, emergency surgery, and age (2 wks) were important determinants of red blood cell transfusion, whereas none of the respondents' personal characteristics were. The average volume of packed red blood cells transfused in the four scenarios did not differ significantly.ConclusionsThis survey documented a significant variation in transfusion practice patterns among pediatric critical care practitioners with respect to the threshold hemoglobin concentration for red blood cell transfusion. The volume of packed red blood cells given was not adjusted to the hemoglobin concentration.

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