{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:52:57Z","timestamp":1777485177651,"version":"3.51.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,5,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Packed red blood cell transfusion may improve oxygen content in single\u2010ventricle neonates, but its effect on clinical outcomes after Stage 1 palliation is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Retrospective multicenter analysis of packed red blood cell transfusion exposures in neonates after Stage 1 palliation, excluding those with intraoperative mortality or need for extracorporeal membrane oxygenation. Transfusion practice variability was assessed, and multivariable regression used to identify transfusion risk factors. After propensity score adjustment for severity of illness, clinical outcomes were compared between transfused and nontransfused subjects. Of 396 subjects, 323 (82%) received 930 postoperative red blood cell transfusions. Packed red blood cell volume (median 9\u201342\u00a0mL\/kg [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001]), donor exposures (1\u20132 [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001]), transfusion number (1\u20133 [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001]), and pretransfusion hemoglobin (12.1\u201313\u00a0g\/dL,\n              <jats:italic>P<\/jats:italic>\n              =0.0049) varied between sites. Cyanosis (\n              <jats:italic>P<\/jats:italic>\n              =0.02), chest tube output (\n              <jats:italic>P<\/jats:italic>\n              =0.0003), and delayed sternal closure (\n              <jats:italic>P<\/jats:italic>\n              =0.0033) increased transfusion risk. Transfusion was associated with prolonged mechanical ventilation (6 [interquartile range 4, 12] versus 3 [1, 5] days,\n              <jats:italic>P<\/jats:italic>\n              =0.02) and intensive care unit stay (19 [12, 33] versus 9 [6, 19] days,\n              <jats:italic>P<\/jats:italic>\n              =0.016). When stratified by number of transfusions (0, 1, or &gt;1), duration of mechanical ventilation (3 [1, 5] versus 4 [3, 6] versus 9 [5, 16] days [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001]) and intensive care unit stay (9 [6, 19] versus 13 [8, 25] versus 21 [13, 38] days [\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001]) increased for those transfused more than once. Most subjects who died were transfused, though the association with mortality was not significant.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Packed red blood cell transfusion after Stage 1 palliation is common, and transfusion practice is variable. Transfusion is a significant predictor of longer intensive care unit stay and mechanical ventilation. Further studies to define evidence\u2010based transfusion thresholds are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.015304","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T09:02:12Z","timestamp":1589187732000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Red Blood Cell Transfusion After Stage I Palliation Is Associated With Worse Clinical Outcomes"],"prefix":"10.1161","volume":"9","author":[{"given":"Felina K.","family":"Mille","sequence":"first","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya","family":"Badheka","sequence":"additional","affiliation":[{"name":"University of Iowa Stead Family Children\u2019s Hospital Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla","family":"Yu","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F.","family":"Friedman","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kheir","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"van den Bosch","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio G.","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier J.","family":"Lasa","sequence":"additional","affiliation":[{"name":"Texas Children\u2019s Hospital Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Katcoff","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Hu","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Borasino","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krissie","family":"Hock","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Huskey","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Weller","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsh","family":"Kothari","sequence":"additional","affiliation":[{"name":"University of Iowa Stead Family Children\u2019s Hospital Iowa City IA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Blinder","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital of Philadelphia Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31819370a9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13908-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000170943.23633.47"},{"key":"e_1_3_2_5_2","first-page":"1","article-title":"Epidemiology and outcomes of pediatric multiple organ dysfunction syndrome (MODS)","volume":"18","author":"Watson R","year":"2018","unstructured":"Watson R, Crow S, Hartman M, Lacroix J, Odetola F. Epidemiology and outcomes of pediatric multiple organ dysfunction syndrome (MODS). Pediatr Crit Care Med. 2018;18:1\u201327.","journal-title":"Pediatr Crit Care Med"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12290"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.022"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.04.028"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03464.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.04.033"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001483"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200711-1637OC"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182745472"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.09.085"},{"key":"e_1_3_2_15_2","first-page":"2213","article-title":"Transfusion strategies for patients in pediatric intensive care units","volume":"536","author":"Lacroix J","year":"2007","unstructured":"Lacroix J, H\u00e9bert P, Hutchison J, Hume H, Tucci M, Ducruet T, Gauvin F, Collet JP, Toledano B, Robillard P, et\u00a0al. Transfusion strategies for patients in pediatric intensive care units. N Engl J Med. 2007;536:2213\u20132224.","journal-title":"N Engl J Med"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181bc816c"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.05.049"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181e329db"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-011-9901-3"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1147-z"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.01.064"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.05.019"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00198-7"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.05.012"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.8.2226"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181b806fc"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001603"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000654"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951119002385"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0741-9"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcibr023045"},{"key":"e_1_3_2_32_2","first-page":"187","article-title":"Red blood cell storage lesion","volume":"9","author":"Kor D","year":"2009","unstructured":"Kor D, Van Buskirk C, Gajic O. Red blood cell storage lesion. J Vet Emerg Crit Care. 2009;9:187\u2013199.","journal-title":"J Vet Emerg Crit Care"},{"key":"e_1_3_2_33_2","first-page":"222","article-title":"Red blood cell storage time & transfusion: current practice, concerns & future perspectives","volume":"15","author":"Garc\u00eda\u2010Roa M","year":"2017","unstructured":"Garc\u00eda\u2010Roa M, Del Carmen Vicente\u2010Ayuso M, Bobes A, Pedraza A, Gonz\u00e1lez\u2010Fern\u00e1ndez A, Mart\u00edn M, S\u00e1ez I, Seghatchian J, Guti\u00e9rrez L. Red blood cell storage time & transfusion: current practice, concerns & future perspectives. Blood Transfus. 2017;15:222\u2013231.","journal-title":"Blood Transfus"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.135731"},{"key":"e_1_3_2_35_2","first-page":"441","article-title":"Clinical effects of leucoreduction of blood transfusions","volume":"69","author":"Bilgin Y","year":"2011","unstructured":"Bilgin Y, van de Watering L, Brand A. Clinical effects of leucoreduction of blood transfusions. Neth J Med. 2011;69:441\u2013450.","journal-title":"Neth J Med"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.04.039"},{"key":"e_1_3_2_37_2","first-page":"2209","article-title":"Technical performance score is associated with outcomes after the Norwood procedure","volume":"148","author":"Nathan M","year":"2014","unstructured":"Nathan M, Sleeper L, Ohye R, Frommelt P, Caldarone C, Tweddell J, Lu M, Pearson G, Gaynor W, Pizarro C. Technical performance score is associated with outcomes after the Norwood procedure. J Thorac Cardiovasc Surg. 2014;148:2209\u20132212.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.119.015304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:56:36Z","timestamp":1715601396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.119.015304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,5,18]]}},"alternative-id":["10.1161\/JAHA.119.015304"],"URL":"https:\/\/doi.org\/10.1161\/jaha.119.015304","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,18]]},"assertion":[{"value":"2019-11-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e015304"}}