To give or not to give? Blood for pediatric trauma patients prior to pediatric trauma center arrival.
Pediatr Surg Int
; 38(2): 285-293, 2022 Feb.
Article
in En
| MEDLINE
| ID: mdl-34605987
ABSTRACT
PURPOSE:
This study evaluates the indications, safety and clinical outcomes associated with the administration of blood products prior to arrival at a pediatric trauma center (prePTC).METHODS:
Children (≤ 18 years) who were highest level activations at an ACS level 1 pediatric trauma center (PTC) from 2009-2019 were divided into groups(1) patients with transport times < 4 h who received blood prePTC(preBlood) versus (2) age matched controls with transport times < 4 h who only received crystalloid prePTC (preCrystalloid).RESULTS:
Of 1269 trauma activations, 38 met preBlood and 38 met preCrystalloid inclusion criteria. A similar volume of prePTC crystalloid infusion was observed between cohorts (p = 0.311). PreBlood patients evidenced greater hemodynamic instability as demonstrated by higher prePTC pediatric age-adjusted shock index (SIPA) scores. PreBlood patients showed improvement in lactate (p = 0.038) and hemoglobin (p = 0.041) levels upon PTC arrival. PreBlood patients received less crystalloid within 12 h of PTC admission (p = 0.017). No significant differences were found in blood transfusion volumes within six (p = 0.293) and twenty-four (p = 0.575) hours of admission, nor in mortality between cohorts (p = 0.091).CONCLUSIONS:
The administration of blood to pediatric trauma patients prior to arrival at a PTC is safe, transiently improves markers of shock, and was not associated with worse outcomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock
/
Wounds and Injuries
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2022
Document type:
Article
Affiliation country:
United States