Massive transfusion in pediatric trauma: An ATOMAC perspective

Space: StayCurrentMD Author: Daniel K. Noland, Nadja Apelt, Cynthia Greenwell, Jefferson Tweed, David M. Notrica, Nilda M. Garcia, R. Todd Maxson, James W. Eubanks, Adam C. Alder Published:

Author / Expert

Daniel K. Noland, Nadja Apelt, Cynthia Greenwell, Jefferson Tweed, David M. Notrica, Nilda M. Garcia, R. Todd Maxson, James W. Eubanks, Adam C. Alder

Topic overview

Abstract

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 

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