The effect of massive transfusion protocol implementation on pediatric trauma care

Area of Science:

• Pediatric Trauma Care
• Hemorrhage Management
• Massive Transfusion Protocols

Background:

• Massive transfusion protocols (MTPs) for pediatric hemorrhage are understudied.
• The impact of MTP implementation on outcomes in injured children requires further investigation.

Purpose of the Study:

• To determine the effect of MTP implementation on outcomes of injured children.
• To evaluate changes in blood product ratios and patient outcomes after MTP adoption.

Main Methods:

• Retrospective comparison of injured children (<18 years) before and after MTP implementation (2005-2014).
• Subgroup analysis based on massive transfusion criteria (≥40 mL/kg RBCs or ≥80 mL/kg total blood products).
• Primary outcome: in-hospital mortality; secondary outcomes: blood product use, ICU/ventilator/pressor-free days, composite morbidity, Glasgow Outcome Score.

Main Results:

• No significant difference in in-hospital mortality between pre-MTP (24%) and post-MTP (19%) groups.
• Massively transfused children post-MTP showed higher plasma:RBC and platelet:RBC ratios (>1:1).
• No differences observed in total blood product use or secondary outcomes.

Conclusions:

• MTP implementation in pediatric trauma did not improve patient outcomes like mortality or morbidity.
• MTPs were associated with improved plasma and platelet transfusion ratios.
• Further research is needed to optimize MTPs for pediatric hemorrhage management.