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Red Blood Cell Transfusion in Pediatric Acute Respiratory Distress Syndrome

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Pediatric Acute Respiratory Distress Syndrome

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Abstract

In the patient with ARDS, as lung function deteriorates, RBC transfusion is often prescribed in an effort to increase oxygen delivery. Though transfusion can increase oxygen delivery, RBC transfusion is associated with worsened markers of lung function and with adverse clinical outcomes in critically ill adults and children, and preclinical data suggest that RBC products can directly injure pulmonary cells and worsen lung function by a variety of mechanisms. This chapter outlines clinical studies of RBC transfusion in pediatric ARDS (PARDS), reviews RBC transfusion-related pathophysiology as it relates to the patient with PARDS, and highlights opportunities for future research to guide optimum transfusion strategies for critically ill children with PARDS.

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Abbreviations

ALI:

Acute lung injury

ARDS:

Acute respiratory distress syndrome

CFH:

Cell-free hemoglobin

NO:

Nitric oxide

RBC:

Red blood cell

TACO:

Transfusion-associated circulatory overload

TLR-4:

Toll-like receptor-4

TRALI:

Transfusion-related acute lung injury

TRIM:

Transfusion-related immunomodulation

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Author information

Authors and Affiliations

  1. St. Louis Children’s Hospital/Barnes Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA

    Kenneth E. Remy

  2. Saint Louis University School of Medicine, St. Louis, MO, USA

    Daniel A. Mannion

  3. Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA

    Jennifer A. Muszynski

Authors
  1. Kenneth E. Remy
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  2. Daniel A. Mannion
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  3. Jennifer A. Muszynski
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Corresponding author

Correspondence to Kenneth E. Remy .

Editor information

Editors and Affiliations

  1. Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    Steven L. Shein

  2. Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA

    Alexandre T. Rotta

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Remy, K.E., Mannion, D.A., Muszynski, J.A. (2020). Red Blood Cell Transfusion in Pediatric Acute Respiratory Distress Syndrome. In: Shein, S., Rotta, A. (eds) Pediatric Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-21840-9_14

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  • DOI: https://doi.org/10.1007/978-3-030-21840-9_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21839-3

  • Online ISBN: 978-3-030-21840-9

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