Early vasopressor administration in pediatric blunt liver and spleen injury: An ATOMAC+ study

Multicenter prospective study of 1004 children with blunt liver/spleen injuries found early vasopressor use (<48h) associated with 7-11 fold increased mortality risk but no impact on nonoperative management failure. All vasopressor-related deaths occurred within 12 hours of injury, highlighting critical early resuscitation challenges in pediatric abdominal trauma.