Elevated international normalized ratio is correlated with large volume transfusion in pediatric trauma patients

Mackenzie, D Graham; Briatico, Daniel; Livingston, Michael H.; Beshay, Tony; Robinson, Tessa; Farrokhyar, Forough; Bailey, Karen

doi:10.1016/j.jpedsurg.2021.12.050

Cited by 2 publications

(2 citation statements)

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“…The first element of this research priority is to improve early identification of shock in pediatric trauma patients in the prehospital and early resuscitation phase. Significant work has already started in improving identification of these patients with pediatric specific scoring systems 11–14 . Continued refinement to improve the performance of these scores across different pediatric age spectrums, education about these scores and their predictive ability, and addressing the challenges of implementation of these scores in out-of-hospital and hospital settings is needed.…”

Section: Resultsmentioning

confidence: 99%

“…Significant work has already started in improving identification of these patients with pediatric specific scoring systems. [11][12][13][14] Continued refinement to improve the performance of these scores across different pediatric age spectrums, education about these scores and their predictive ability, and addressing the challenges of implementation of these scores in out-of-hospital and hospital settings is needed. Once these scores have been appropriately refined, there should be consideration to implement these scores into the electronic medical record for real-time utilization by bedside clinicians.…”

Section: Research Priority 1: Improvement In the Prompt Identificatio...mentioning

confidence: 99%

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Pediatric Traumatic Hemorrhagic Shock Consensus Conference Research Priorities

Russell

Bembea

Borgman

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND: Traumatic injury is the leading cause of death in children and adolescents. Hemorrhagic shock remains a common and preventable cause of death in the pediatric trauma patients. A paucity of high-quality evidence is available to guide specific aspects of hemorrhage control in this population. We sought to identify high-priority research topics for the care of pediatric trauma patients in hemorrhagic shock. METHODS:A panel of 16 consensus multidisciplinary committee members from the Pediatric Traumatic Hemorrhagic Shock Consensus Conference developed research priorities for addressing knowledge gaps in the care of injured children and adolescents in hemorrhagic shock. These ideas were informed by a systematic review of topics in this area and a discussion of these areas in the consensus conference. Research priorities were synthesized along themes and prioritized by anonymous voting. RESULTS:Eleven research priorities that warrant additional investigation were identified by the consensus committee. Areas of proposed study included well-designed clinical trials and evaluations, including increasing the speed and accuracy of identifying and treating hemorrhagic shock, defining the role of whole blood and tranexamic acid use, and assessment of the utility and appropriate use of viscoelastic techniques during early resuscitation. The committee recommended the need to standardize essential definitions, data elements, and data collection to facilitate research in this area. CONCLUSION: Research gaps remain in many areas related to the care of hemorrhagic shock after pediatric injury. Addressing these gaps is needed to develop improved evidence-based recommendations for the care of pediatric trauma patients in hemorrhagic shock.

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Section: Resultsmentioning

confidence: 99%