Massive transfusion in pediatric trauma: An ATOMAC perspective
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In brief
In brief
Multi-center study of 110 pediatric trauma patients requiring massive transfusion across five Level I centers (2007-2013) examined survival outcomes and optimal blood component ratios. Overall survival was 73%, with coagulopathy markers (PTT, INR) and injury severity significantly associated with mortality, while arrival hemoglobin did not predict outcomes.
Written by the GCMD Library team from the article.
Background/Purpose
Massive transfusion protocols (MTPs) are considered valuable in pediatric trauma. Important questions regarding the survival benefit and optimal blood component ratio remain unknown.
Methods
The study time frame was January 2007 through December 2013 five Level I Pediatric Trauma Centers reviewed all trauma activations involving children ≤18 years of age. Included were patients who either had the institutional MTP or received >20 mL/kg or > 2 units packed red blood cells (PRBCs).
Results
110/202 qualified for inclusion. Median age was 5.9 years (3.0–11.4). 73% survived to discharge; median hospitalization was 10 (3.1–22.8) days. Survival did not vary by arrival hemoglobin (Hgb), gender or age. Partial prothrombin time (PTT), INR, GCS and injury severity score (ISS) significantly differed for nonsurvivors (all p