Quick Literature Updates Episode 10
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- Life-threatening bleeding in children differs from adults; prospective study across 24 centers examined traumatic, operative, and medical bleeding.
- High compliance with 8-part perioperative care bundle significantly reduced superficial SSI rates in pediatric colorectal surgery.
- Contrast enema before stoma reversal detected 92% of strictures but appears most useful in necrotizing enterocolitis patients (95% of strictures).
- Massive transfusion protocol criteria: >40 cc/kg blood products over 6 hours or activation of institutional MTP.
- Standardized perioperative protocols decrease morbidity and improve outcomes in high-risk pediatric colorectal procedures.
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Hello Pediatric Surgery family. I'm M. Tumbush, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stakern, we are sharing knowledge to improve child health around the globe. Today, our team is going to deliver the articles that you should know about. We have three papers today. The first one is from critical care medicine, and the others from the Journal of Pediatric Surgery. We don't have much time, so let's start. Our first paper titled life-threatening bleeding in children, a prospective observational study by Leonard at all. This paper is summarized by Ellen Ann Cisco. She was a research fellow at Cincinnati Children's Hospital, and as of this month, she's back to being a general surgery resident at Mayo Clinic. The researchers here wanted to take a look at children with life threatening bleeding events and learn more about them, because as we know, children are different than adults. They did a prospective observational study of children presenting with life threatening bleeding events across 24 centers between the US, Canada, and Italy. Kids were eligible if they received more than 40 ccs per kilo of total blood products over six hours, or if they were transfused under massive transfusion protocol or MTP. The authors compared patients presenting with traumatic bleeding, operative bleeding, and medical bleeding. The authors found out a lot about this patient population. To learn more and see all the details, click the link below. Awesome. Our second paper is standardized perioperative care reduces colorectal surgical site infection in children. A Western Pediatric Surgery Research Consortium multi-center analysis by Tobias at all. And this paper is summarized by Alex Halpern. He is one of our contributors here at Stakern MD and a general surgery resident at George Washington University. The Western Pediatric Surgery Research Consortium conducted a prospective cohort study on children undergoing colorectal surgery across 10 hospitals in the US. They utilized an eight-part perioperative care bundle and split children into either a high or low compliance group. They found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group. Showing that standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery. Great. Moving to the last paper of today. Here is routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis, an evaluation of the diagnostic accuracy of the contrast enema by Efting Scharincark at all. This one is summarized by Cecilia Jiena. She is a research fellow at Cincinnati Children's Hospital. This is a retrospective study done in Netherlands between 1998 and 2018. They looked at patients under three years old that got a stoma reversal to see if they had contrast enema prior to it and if they were able to detect strictures. They gathered 244 patients. Of them, 10% got strictures. 95% had a necrotizing enterocolitis. Of all the patients, only 68% had a contrast enema prior to the stoma reversal. And able to detect 92% of the structures. So, it seems that contrast enema prior to stoma reversal is only useful if patients had neck. Check the link in the description below to read each paper. We hope you like this episode. Please follow us on social media, give us a rating, and subscribe to our YouTube channel. And don't forget to download our Stakern app on App Store or Play Store for more content. Thank you for listening. Cincinnati Children's Hospital and Stakern are sharing knowledge to improve child health around the globe.