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Case report
Paediatric palliative care: why transfuse?
  1. Guillaume Robert1,2,3,
  2. Celine Chappe4,
  3. Ana Ferreira2,
  4. Elisabeth MC Ewan1 and
  5. Sara Calmanti2
  1. 1 Palliative Care Centre, University Hospital, Rennes, Bretagne, France
  2. 2 Paediatric Palliative Care Regional Team - ERRSPP Bretagne - La Brise, Rennes, Bretagne, France
  3. 3 Université Rennes 1, Rennes, Bretagne, France
  4. 4 Paediatric Oncology Unit, University Hospital, Rennes, Bretagne, France
  1. Correspondence to Dr Guillaume Robert, University Hospital Centre Rennes, Rennes 35000, France; guillaume.robert{at}chu-rennes.fr

Abstract

Should indication for transfusion in paediatric palliative care be based on the child’s perspective rather than the biological results? An 8-year-old boy presenting a relapse of a stage IV neuroblastoma received regular blood transfusions. A severe exophtalmia led the doctors to question the transfusion strategy. Over 7.5 months, the child received 56 red blood cell units and 31 platelet units. He was hospitalised 50 times. Indication for blood test and transfusion may be regularly and collegially reassessed. Transfusion needs in a palliative strategy can be as high as in a curative strategy. Practices, benefits but also ethical and public health dimensions should be more studied.

  • supportive care
  • cancer
  • paediatrics
  • home care
  • clinical decisions
  • ethics

https://doi.org/10.1136/bmjspcare-2020-002582

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    Footnotes

    • Contributors GR, CC, AF and SC were care providers for the child and took part to the palliative care pathway and decisions about the child. EMCE contributed to the analysis of the case and English language correction. All authors contributed to the writing and rereading of the manuscript. GR is responsible for the overvall content as guarantor and main writer.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.