Transfusion Volume for Children with Severe Anemia in Africa.

The New England Journal of Medicine
Kathryn MaitlandTRACT Group

Abstract

Severe anemia (hemoglobin level, <6 g per deciliter) is a leading cause of hospital admission and death in children in sub-Saharan Africa. The World Health Organization recommends transfusion of 20 ml of whole-blood equivalent per kilogram of body weight for anemia, regardless of hemoglobin level. In this factorial, open-label trial, we randomly assigned Ugandan and Malawian children 2 months to 12 years of age with a hemoglobin level of less than 6 g per deciliter and severity features (e.g., respiratory distress or reduced consciousness) to receive immediate blood transfusion with 20 ml per kilogram or 30 ml per kilogram. Three other randomized analyses investigated immediate as compared with no immediate transfusion, the administration of postdischarge micronutrients, and postdischarge prophylaxis with trimethoprim-sulfamethoxazole. The primary outcome was 28-day mortality. A total of 3196 eligible children (median age, 37 months; 2050 [64.1%] with malaria) were assigned to receive a transfusion of 30 ml per kilogram (1598 children) or 20 ml per kilogram (1598 children) and were followed for 180 days. A total of 1592 children (99.6%) in the higher-volume group and 1596 (99.9%) in the lower-volume group started transfusion (m...Continue Reading

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Citations

Aug 1, 2019·The New England Journal of Medicine·Julie R Ingelfinger
Apr 2, 2020·Intensive Care Medicine·Katherine L Brown, Daniele De Luca
Oct 24, 2019·The New England Journal of Medicine·Kathryn MaitlandA Sarah Walker
Sep 5, 2020·Malaria Journal·Peter Olupot-OlupotThomas N Williams
Oct 24, 2019·The New England Journal of Medicine·Tomohiko SatoTetsunori Tasaki
Dec 3, 2020·The New England Journal of Medicine·Titus K KwambaiFeiko O Ter Kuile
Sep 10, 2020·The American Journal of Tropical Medicine and Hygiene·George Dennis Shanks
Jan 15, 2021·Wellcome Open Research·Moses M NgariJames A Berkley
Apr 28, 2021·Intensive Care Medicine·Mark J PetersElizabeth Molyneux
May 7, 2021·British Journal of Haematology·Kathryn MaitlandUNKNOWN TRACT Stakeholders meeting group
May 17, 2021·British Journal of Haematology·Sophie UyogaKathryn Maitland

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