The effect of massive transfusion protocol implementation on pediatric trauma care.
The effect of massive transfusion protocol implementation on pediatric trauma care.
复制标题
DOI：
10.1111/trf.13781
复制
发表时间：
2016-11
期刊：
影响因子：
2.9
通讯作者：
Leonard JC
中科院分区：
文献类型：
--
作者：
Hwu RS;Spinella PC;Keller MS;Baker D;Wallendorf M;Leonard JC
Massive transfusion protocols (MTPs) to address hemorrhage are under-studied in children. The objective was to determine the effect of MTP implementation on outcomes of injured children. This retrospective comparison of injured children before and after MTP implementation for children <18 yo who presented in 2005–2014 and received red blood cells (RBC) within 24 hours of arrival. Children were divided into groups based on pre-/post-MTP implementation and sub-grouped based on receipt of massive transfusion (≥40 ml/kg PRBC or ≥80 ml/kg total blood products at 24 hours from arrival). The primary outcome was in-hospital mortality and secondary outcomes were total blood product use, intensive care unit (ICU)/ventilator/pressor-free days, composite morbidity and Glasgow Outcome Score (GOS). 11,995 children presented for trauma care over 9 years; 235 received RBCs. 120 were in the pre-MTP group and 115 in the post-MTP, of which 26 and 17 received massive transfusion in the pre and post-MTP groups, respectively; 11 had MTP activations. Children massively transfused post-MTP received mean plasma:RBC and platelet:RBC ratios greater than 1:1 at both 6 and 24 hours with no significant difference in total admission blood product use. There was no difference in in-hospital mortality between pre- and post-MTP groups (24% vs. 19%) or massive transfusion subgroups (54% vs. 47%). There were no differences in secondary outcomes. While we were not able to show improvements in outcome, MTP implementation led to higher plasma and platelet:RBC ratios without an associated change in blood product use or composite morbidity.
登录
查看更多内容
DOI：
10.1097/ta.0b013e318174e8bc
发表时间：
2008-06-01
影响因子：
--
作者：
Niles, Sarah E.;McLaughlin, Daniel F.;Holcomb, John B.
通讯作者：
Holcomb, John B.
影响因子：
3
作者：
BAKER, CC;OPPENHEIMER, L;TRUNKEY, DD
通讯作者：
TRUNKEY, DD
DOI：
10.1097/ta.0b013e3181cf7f2a
发表时间：
2010-02-01
影响因子：
--
作者：
Dente, Christopher J.;Shaz, Beth H.;Ingram, Walter L.
通讯作者：
Ingram, Walter L.
影响因子：
2.7
作者：
Borgman MA;Spinella PC;Holcomb JB;Blackbourne LH;Wade CE;Lefering R;Bouillon B;Maegele M
通讯作者：
Maegele M
影响因子：
2.9
作者：
Hendrickson, Jeanne E.;Shaz, Beth H.;Josephson, Cassandra D.
通讯作者：
Josephson, Cassandra D.