Association of Blood Component Ratios With 24-Hour Mortality in Injured Children Receiving Massive Transfusion.
Crit Care Med
; 47(7): 975-983, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31205079
ABSTRACT
OBJECTIVES:
To determine if higher fresh frozen plasma and platelet to packed RBC ratios are associated with lower 24-hour mortality in bleeding pediatric trauma patients.DESIGN:
Retrospective cohort study using the Pediatric Trauma Quality Improvement Program Database from 2014 to 2016.SETTING:
Level I and II pediatric trauma centers participating in the Trauma Quality Improvement Program PATIENTS Injured children (≤ 14 yr old) who received massive transfusion (≥ 40 mL/kg total blood products in 24 hr). Of 123,836 patients, 590 underwent massive transfusion, of which 583 met inclusion criteria.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Ratios of fresh frozen plasmapacked RBC and plateletpacked RBC. Of the 583 patients, 60% were male and the median age was 5 years (interquartile range, 2-10 yr). Overall mortality was 19.7% (95% CI, 16.6-23.2%) at 24 hours. There was 51% (adjusted relative risk, 0.49; 95% CI, 0.27-0.87; p = 0.02) and 40% (adjusted relative risk, 0.60; 95% CI, 0.39-0.92; p = 0.02) lower risk of death at 24 hours for the high (≥ 11) and medium (≥ 12 and < 11) fresh frozen plasmapacked RBC ratio groups, respectively, compared with the low ratio group (< 12). Plateletpacked RBC ratio was not associated with mortality (adjusted relative risk, 0.94; 95% CI, 0.51-1.71; p = 0.83).CONCLUSIONS:
Higher fresh frozen plasma ratios were associated with lower 24-hour mortality in massively transfused pediatric trauma patients. The platelet ratio was not associated with mortality. Although these findings represent the largest study evaluating blood product ratios in pediatric trauma patients, prospective studies are necessary to determine the optimum blood product ratios to minimize mortality in this population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Transfusão de Componentes Sanguíneos
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Hemorragia
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article