A pediatric massive transfusion protocol

Chidester, Sara J.; Williams, Nick; Wang, Wei; Groner, Judith A.

doi:10.1097/ta.0b013e318265d267

Cited by 105 publications

(84 citation statements)

References 21 publications

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“…Large, prospective observation studies of injured children requiring massive transfusion are currently ongoing and will provide greater insight on optimization of blood product administration. Until further information does come to light, the presumed benefits of balanced blood product administration have led many US pediatric trauma centers to adopt modified versions of adult massive transfusion protocols [30,32,33].…”

Section: Blood Transfusionmentioning

confidence: 99%

“…Along with these retrospective studies, several prospective observational studies have sought to further refine current trauma transfusion practices [27]. The widespread and enthusiastic adoption of Bbalance resuscitation^practices in the adult population has translated into changes in pediatric care as well [28][29][30][31][32][33]. This shift in balanced resuscitation for injured children, however, has not been thoroughly studied due to the relative infrequency of massive transfusions in children.…”

Section: Blood Transfusionmentioning

confidence: 99%

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Pediatric Combat Trauma

Russo

Neff

2016

Curr Trauma Rep

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Purpose of review Military physicians have amassed tremendous experience treating children with combat-related injuries in Iraq and Afghanistan. This review will present several treatment principles adapted from adult trauma care that were applied to children in war and consider their selective application in civilian practice. Recent findings Many standard practices of adult trauma care were applied to the management of war-injured children. Initial reports of tourniquet use, tranexamic acid administration, and balanced blood transfusion suggest a benefit to the pediatric population. Constraints of providing intensive care in an austere environment required a shift in management toward aggressive limb salvage over amputation, and early palliation for severe brain injury or extensive burns.Summary Despite the obstacles that may limit the direct translation of trauma care principals to civilian settings, these wartime experiences offer robust and excellent preliminary data that might inform future investigations in the field of pediatric trauma care.

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Section: Blood Transfusionmentioning

confidence: 99%

Section: Blood Transfusionmentioning

confidence: 99%

Pediatric Combat Trauma

Russo

Neff

2016

Curr Trauma Rep

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“…Kanın alınması, muhafazası ve transfüzyon işlemi uygun bir şekilde yapıldığında masif transfüzyon yaşam kurtarıcı bir işlemdir. Hastaya 1 saat içinde 4 üniteden daha fazla ES transfüzyonu yapılacaksa o zaman masif transfüzyon protokolleri uygulanarak dengeli kan (ES: TDP: Plt) transfüzyonu yapılmalıdır (5)(6)(7)(8) .…”

Section: Masif Transfüzyon Ne Demektir Ve Hangi Durumlarda Yapılmalıdır?unclassified

Blood Transfusion and Massive Transfusion Protocols in War and Terror

Kılbaş¹,

Kaymak²

2017

Okmeydani Medical Journal

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“…The value of aggressive blood product transfusion using MTPs for the pediatric patient with massive hemorrhage requires further prospective validation [70][71][72][73].…”

Section: Massive Transfusion Protocolmentioning

confidence: 99%

Perioperative bleeding management in pediatric patients

Goobie

Haas

2016

Current Opinion in Anaesthesiology

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PURPOSE OF REVIEW Managing the bleeding pediatric patient perioperatively can be extremely challenging. The primary goals include avoiding hypotension, maintaining adequate tissue perfusion and oxygenation, and maintaining hemostasis. Traditional bleeding management has consisted of transfusion of autologous blood products, however, there is strong evidence that transfusion-related side-effects are associated with increased morbidity and mortality in children. Especially concerning is the increased reported incidence of noninfectious adverse events such as transfusion-related acute lung injury, transfusion-related circulatory overload and transfusion-related immunomodulation. The current approach in perioperative bleeding management of the pediatric patient should focus on the diagnosis and treatment of anemia and coagulopathy with the transfusion of blood products only when clinically indicated and guided by goal-directed strategies. RECENT FINDINGS Current guidelines recommend that a comprehensive multimodal patient blood management strategy is critical in optimizing patient care, avoiding unnecessary transfusion of blood and blood product and limiting transfusion-related sideeffects. SUMMARY This article will highlight current guidelines in perioperative bleeding management for our most vulnerable pediatric patients with emphasis on individualized targeted intervention using point-of-care testing and specific coagulation products. Purpose of review Managing the bleeding pediatric patient perioperatively can be extremely challenging. The primary goals include avoiding hypotension, maintaining adequate tissue perfusion and oxygenation, and maintaining hemostasis. Traditional bleeding management has consisted of transfusion of autologous blood products, however, there is strong evidence that transfusion-related side-effects are associated with increased morbidity and mortality in children. Especially concerning is the increased reported incidence of noninfectious adverse events such as transfusion-related acute lung injury, transfusion-related circulatory overload and transfusion-related immunomodulation. The current approach in perioperative bleeding management of the pediatric patient should focus on the diagnosis and treatment of anemia and coagulopathy with the transfusion of blood products only when clinically indicated and guided by goaldirected strategies. Recent findingsCurrent guidelines recommend that a comprehensive multimodal patient blood management strategy is critical in optimizing patient care, avoiding unnecessary transfusion of blood and blood product and limiting transfusion-related side-effects. SummaryThis article will highlight current guidelines in perioperative bleeding management for our most vulnerable pediatric patients with emphasis on individualized targeted intervention using point-of-care testing and specific coagulation products.

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A pediatric massive transfusion protocol

Cited by 105 publications

References 21 publications

Pediatric Combat Trauma

Pediatric Combat Trauma

Blood Transfusion and Massive Transfusion Protocols in War and Terror

Perioperative bleeding management in pediatric patients

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