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

作者：Nosanov Lauren; Inaba Kenji^*; Okoye Obi; Resnick Shelby; Upperman Jeffrey; Shulman Ira; Rhee Peter; Demetriades Demetrios

来源：American Journal of Surgery, 2013, 206(5): 655-660.

DOI：10.1016/j.amjsurg.2013.07.009

• Pediatrics
• Trauma
• Massive transfusion protocol
• Hemorrhage
• Coagulopathy

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.

• 出版日期2013-11