Related Experiment Video
Updated: Feb 2, 2026
A Saline/Bipolar Radiofrequency Energy Device As an Adjunct for Hemostasis in Solid Organ Injury/Trauma
Published on: July 28, 2020
Reduction of resource utilization in children with blunt solid organ injury
Micah G Katz1, Zachary J Kastenberg2, Mark A Taylor1
1Department of Surgery, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132.
Insights
Shifting from a grade-based to a hemodynamic stability protocol for blunt solid organ injuries significantly reduced intensive care unit (ICU) admissions in children. This new approach proved safe and efficient, optimizing resource use.
Area of Science:
- Pediatric Trauma Surgery
- Emergency Medicine
- Surgical Critical Care
Background:
- Nonoperative management of blunt solid organ injuries is advancing.
- Current practices aim for cost-effectiveness and patient safety.
- Admission criteria protocols are evolving.
Purpose of the Study:
- To compare resource utilization and patient outcomes.
- To evaluate a new protocol based on hemodynamic stability versus a grade-based system.
- To assess the impact of changing admission criteria for blunt solid organ injuries.
Main Methods:
- Retrospective review of isolated liver and spleen injuries.
- Comparison of data from two years before and two years after protocol change (2013-2017).
- Utilized prospectively collected trauma registry data; SAS 9.4 for analysis.
Main Results:
- 121 patients in the pre-protocol cohort, 125 in the post-protocol cohort.
- Intensive Care Unit (ICU) admission rate decreased from 40% to 22% (p=0.002).
- No adverse events occurred on the floor; no patients required ICU transfer.
Conclusions:
- Physiologic derangement-based ICU admission protocol reduced rates in pediatric solid organ injury.
- The protocol was safe and effective.
- Resource utilization was significantly reduced.
Background/Purpose:
Nonoperative management of blunt solid organ injuries continues to progress and improve cost-effective utilization of resources while maximizing patient safety. The purpose of this study is to compare resource utilization and patient outcomes after changing admission criteria from a grade-based protocol to one based on hemodynamic stability.
Methods:
A retrospective review of isolated liver and spleen injuries was done using prospectively collected trauma registry data from 2013 to 2017. The 2 years preceding the change were compared to the 2 years after protocol change. All analyses were performed using SAS 9.4.
Results:
There were 121 patients in the preprotocol cohort and 125 patients in the postprotocol cohort. Baseline demographics were similar along with injury mechanisms and severity. The ICU admission rate decreased from 40% to 22% (p = 0.002). There were no adverse events on the floor and no patient needed to be transferred to the ICU.
Conclusions:
A protocol for ICU admission based on physiologic derangement versus solely on radiologic grade significantly reduced admission rates to the ICU in children with solid organ injury. The protocol was safe and effectively reduced resource utilization.
Level Of Evidence:
Level II, prospective comparison study.
Related Concept Videos
01:19Oxidation and Reduction of Organic Molecules
The removal of an electron from a molecule, results in a...
02:37Metallic Solids
All metallic solids exhibit high thermal and electrical conductivity, metallic luster, and malleability....
02:22Structures of Solids
02:12Short-distance Transport of Resources
01:09Levels of Organization
Molecules Are Composed of Atoms, and Biomolecules Are Assembled from Molecules:
The most basic levels include atoms, molecules, and biomolecules. Atoms, the smallest unit of ordinary matter, are composed of a nucleus and electrons. Molecules...
03:11Oxidation-Reduction Reactions