From
StayCurrentMD
Restrictive Transfusion Policies: 2018 Pediatric Surgery Practice Gap #10
With Dr. Todd Ponsky
Part of
DVT 6 items
Chapter 1 of 2 · Fundamentals
APSA practice gaps
Introduction to APSA Practice Gaps and the 2019 Annual Update Course
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
At a lot of hospitals, when you want to take a NICU baby to the operating room, they mandate that the patient has a hemoglobin of 10.
The APSA Practice Development Committee identified areas that pediatric surgeons don't know about, and specifically areas where surgeons don't know that they don't know about them.
A practice gap is the distance between what is best practices or evidence based (what you should be doing) and what actually happens.
Transfusing to a target hemoglobin of 7 instead of 9 or 10 has no difference in mortality.
Blood transfusions increase the risk of DVT in patients.
The restrictive transfusion policy of 7 (not 9 or 10) will have no difference in mortality, and this applies across the board to pediatric patients, not just trauma patients.
You don't need hemoglobin of 10 for NICU babies going to the OR; if the patient is doing well clinically, they can tolerate lower hemoglobin levels.
