To determine the incidence of anemia among pediatric critical care survivors and to determine whether it resolves within 6 months of discharge. Design. A prospective observational study. Patients with anemia upon discharge from the pediatric critical care unit (PCCU) underwent in hospital and post hospital discharge followup (4–6 months) for hemoglobin (Hb) levels. Setting. A medical-surgical PCCU in a tertiary care center. Patients. Patients aged 28 days to 18 years who were treated in the PCCU for over 24 hours. Measurements and Main Results. 94 (24%) out of 392 eligible patients were anemic at time of discharge. Patients with anemia were older, median 8.0？yrs [(IQR 1.0–14.4) versus 3.2？yrs (IQR 0.65–9.9) ( )], and had higher PeLOD [median 11 (IQR 10–12) versus 1.5 (1–4) ( )], and PRISM [median 5 (IQR 2–11) versus 3 (IQR 0–6) ( )] scores. The Hb level normalized in 32% of patients before discharge from hospital. Of the 28 patients who completed followup, all had normalization of their Hb in the absence of medical intervention. Conclusions. Anemia is not common among patients discharged from the PCCU and recovers spontaneously within 4–6 months. 1. Introduction Anemia is a frequent occurrence in critically ill patients [1] and red blood cell (RBC) transfusions are commonly administered [1–3]. However, adult and pediatric literature suggests that RBC transfusions in the critically ill pose multiple risks [4, 5] and are associated with worsened clinical outcomes [4–7]. Conversely, restrictive transfusion practices with subnormal levels of hemoglobin (Hb) are well tolerated by the critically ill [1, 2, 4] and are associated with improved patient outcomes when compared to a liberal transfusion strategy [8]. While this issue is largely unaddressed in the pediatric population, the only randomized controlled trial in children to date (TRIPICU trial) supports the use of a restrictive transfusion strategy in critically ill children [9]. We postulated that pediatricians would demonstrate a conservative approach to the use of RBC transfusions which would result in a high incidence and magnitude of anemia among patients discharged from the pediatric critical care unit (PCCU). This phenomenon has recently been described in a population of adult intensive care survivors in whom the prevalence of anemia increased to 80% [10]. There is no published data regarding the occurrence of anemia in children after critical care discharge. The objective of this study was to test the hypothesis that anemia is common among patients discharged from the PCCU and to determine the
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