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Aggressive crystalloid adversely affects outcomes in a pediatric trauma population
Hai Zhu1, Bailin Chen1,2, Chunbao Guo3,4,5
1Department of Pediatric General Surgery and Liver Transplantation, Children's Hospital, Chongqing Medical University, 136 Zhongshan 2nd Rd., Chongqing, 400014, People's Republic of China.
Summary
Excessive crystalloid fluid resuscitation in pediatric blunt trauma patients is linked to adverse outcomes like severe anemia and longer hospital stays. Minimizing fluid administration is recommended to improve patient recovery.
Area of Science:
- Trauma resuscitation
- Pediatric critical care
- Fluid management
Background:
- Crystalloid resuscitation in trauma care can be detrimental.
- Minimizing crystalloid administration is a key recommendation.
- Adverse effects of high-volume resuscitation in pediatric blunt trauma require evaluation.
Purpose of the Study:
- To assess the adverse effects of high-volume crystalloid resuscitation.
- To investigate outcomes in pediatric blunt trauma patients receiving different fluid volumes.
Main Methods:
- Retrospective review of 291 pediatric blunt trauma patients.
- Dichotomization into low and high crystalloid volume groups (24/48h cut-offs).
- Propensity score matching to control for confounding factors.
Main Results:
- High-volume crystalloid resuscitation correlated with severe anemia (p=0.033/0.042).
- Increased likelihood of red blood cell (RBC) transfusion (p=0.016/0.009) and longer hospital stay (p=0.008/0.002).
- Marginal differences in plasma transfusion and diet at 24h, significant at 48h (p=0.013).
Conclusions:
- Excessive crystalloid resuscitation within 48 hours leads to significant unfavorable outcomes in pediatric blunt trauma.
- Findings support avoiding excessive fluid resuscitation in this patient population.
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