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Am J Surg. 2013 Nov;206(5):655-60. doi: 10.1016/j.amjsurg.2013.07.009. Epub 2013 Sep 4.

The impact of blood product ratios in massively transfused pediatric trauma patients.

Author information

1
Department of Surgery, Keck School of Medicine, University of Southern California, LAC+USC Medical Center, 2051 Marengo Street, IPT, C5L100, Los Angeles, CA 90033, USA.

Abstract

BACKGROUND:

Few studies have examined the impact of balanced resuscitation in pediatric trauma patients requiring massive transfusions. Adult data may not be generalizable to children.

METHODS:

Retrospective analysis assessed patients seen at a level I trauma center between 2003 and 2010 aged ≤18 years requiring massive packed red blood cell (PRBC) transfusion, defined as transfusion of ≥50% total blood volume. After excluding mortalities in the first 24 hours, the impact of plasma and platelet ratios on mortality was evaluated.

RESULTS:

Of 6,675 pediatric trauma patients, 105 were massively transfused (mean age, 12.4 ± 6.3 years; mean Injury Severity Score, 25.8 ± 11.4; mortality rate, 18.1%). All deceased patients sustained severe head injuries. Plasma/PRBC and platelet/PRBC ratios were not significantly associated with mortality.

CONCLUSIONS:

In this study, higher plasma/PRBC and platelet/PRBC ratios were not associated with increased survival in children. The value of aggressive blood product transfusion for injured pediatric patients requires further prospective validation.

KEYWORDS:

Coagulopathy; Hemorrhage; Massive transfusion protocol; Pediatrics; Trauma

PMID:
24011571
DOI:
10.1016/j.amjsurg.2013.07.009
[Indexed for MEDLINE]

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