Quick Literature Updates Episode 4

Stevens et al. studied two pediatric trauma centers, looking at highest level trauma patients with either blunt solid organ injuries or penetrating injuries who had thromboelastography within first two hours of arrival

TEG abnormalities were not significantly different between blunt solid organ injury and penetrating injury groups

Patients presenting in shock had significant decreases in alpha angle and MA (maximum amplitude) values on thromboelastography

Hemodynamic status or shock may be more predictive of coagulopathy than injury mechanism in pediatric trauma

Short et al. retrospectively reviewed pediatric patients who underwent surgery for inflammatory bowel disease before and after implementation of a multidisciplinary clinic

After implementation of multidisciplinary clinic utilizing ERAS protocols, there was significant decrease in 30-day ER visits post-operatively and 30-day readmission rate for pediatric IBD surgery patients

Approximately 50% of patients with congenital diaphragmatic hernia have gastroesophageal reflux disease

In approximately 30% of hospitals in France and possibly worldwide, surgeons perform fundoplication at time of CDH repair to prophylactically prevent reflux

Montalva et al. conducted 10-year prospective review across 20 hospitals in France examining prophylactic fundoplication at time of CDH repair

Prophylactic fundoplication at time of CDH repair leads to more failure to thrive, more oral aversion, and more need for tube feeds

Patients who had patch repair for CDH had worse GERD more often

Spinella et al. studied 24 children's hospitals across North America and Italy, examining approximately 450 pediatric patients ages 0-17 who received blood through massive transfusion protocol or more than 40 mL/kg over six hours

In pediatric hemorrhage patients who received antifibrinolytic therapy (tranexamic acid or aminocaproic acid), there was reduced mortality at both 6-hour and 24-hour time points