Whole Blood Resuscitation is Safe in Pediatric Trauma Patients: A Multicenter Study

Lindsey L. Perea, Kate Moore, Courtney Docherty, Uyen Nguyen, Mark J. Seamon, James P. Byrne, Donald H. Jenkins, Maxwell A. Braverman, John M. Porter, Isabella G. Armento, Caleb Mentzer, Guy C. Leonard, Alejandro J. Luis, Matthew R. Noorbakhsh, James E. Babowice, Haytham M.A. Kaafarani, Ava Mokhtari, Matthew J. Martin, Jayraan Badiee, Charles MainsRobert M. Madayag, Sarah A. Moore, Kathleen Madden, Joshua P. Hazelton

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Whole blood (WB) resuscitation has been associated with a mortality benefit in trauma patients. Several small series report the safe use of WB in the pediatric trauma population. We performed a subgroup analysis of the pediatric patients from a large prospective multicenter trial comparing patients receiving WB or blood component therapy (BCT) during trauma resuscitation. We hypothesized that WB resuscitation would be safe compared to BCT resuscitation in pediatric trauma patients. Methods: This study included pediatric trauma patients (0-17 y), from ten level-I trauma centers, who received any blood transfusion during initial resuscitation. Patients were included in the WB group if they received at least one unit of WB during their resuscitation, and the BCT group was composed of patients receiving traditional blood product resuscitation. The primary outcome was in-hospital mortality with secondary outcomes being complications. Multivariate logistic regression was performed to assess for mortality and complications in those treated with WB vs BCT. Results: Ninety patients, with both penetrating and blunt mechanisms of injury (MOI), were enrolled in the study (WB: 62 (69%), BCT: 28 (21%)). Whole blood patients were more likely to be male. There were no differences in age, MOI, shock index, or injury severity score between groups. On logistic regression, there was no difference in complications. Mortality was not different between the groups (P =.983). Conclusion: Our data suggest WB resuscitation is safe when compared to BCT resuscitation in the care of critically injured pediatric trauma patients.

Original languageEnglish (US)
Pages (from-to)3058-3063
Number of pages6
JournalAmerican Surgeon
Volume89
Issue number7
DOIs
StatePublished - Jul 2023

Keywords

  • blood component therapy
  • pediatric trauma
  • pediatric whole blood
  • trauma resuscitation
  • whole blood transfusion

ASJC Scopus subject areas

  • Surgery

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