Research Group on Blood Transfusion

Red Blood Cell (RBC) Transfusion-Associated Respiratory Dysfunction (TARD) in Critically Ill Children: a Sub-Study of the TRIPICU Trial

New or progressive multiple organ dysfunction syndrome (MODS) is not rare in pediatric intensive care units and many MODS involve a respiratory dysfunction. It is known that some of these cases of new/progressive respiratory dysfunction are caused by red blood cell (RBC) transfusion, but the incidence of transfusion-associated respiratory dysfunction (TARD) is not well characterized. Moreover, what proportion of TARD are not only associated, but in fact caused by a RBC transfusion is unknown. There are several reasons that suggest that respiratory dysfunction due to the transfusion of red blood cells may be more frequent in critically ill children than that presently reported.

Main Objectives

Compare the incidence rate and severity of cases of new/progressive respiratory dysfunction in 64 critically ill children of Sainte-Justine Hospital who participated to the TRIPICU study and who received a red blood cell transfusion. Compare the incidence rate in those who did not receive a RBC transfusion.

Find if there is a relationship between the cases of new/progressive respiratory dysfunction and a RBC transfusion.

Preliminary Findings

Under the direction of Dr. Jacques Lacroix, Émilie Lefebvre, a medical student, analyzed the TRICPICU international study database with the aim of determining the frequency and severity of respiratory dysfunction in transfused patients in experimental and control groups. In conclusion, respiratory distress (RD) is common in pediatric intensive care unit (PICU) patients. After a transfusion, RD is significantly worse, but the cause-effect relationship between the transfusion of red blood cells (RBC) and RD in PICU remains to be demonstrated.