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Advantages of early intervention with arterial embolization for intra-abdominal solid organ injuries in children
Kubilay Gürünlüoğlu1, İsmail Okan Yıldırım2, Ramazan Kutu2
1Department of Pediatric Surgery, İnönü University School of Medicine, Malatya, Turkey.
Insights
Early percutaneous transcatheter arterial embolization (PTAE) for pediatric blunt abdominal trauma significantly reduces intensive care and hospital stays, lowers costs, and enables earlier feeding compared to delayed embolization.
Area of Science:
- Pediatric Surgery
- Interventional Radiology
- Trauma Management
Background:
- Intra-abdominal hemorrhage from blunt trauma is a critical cause of mortality in children.
- Prompt management is essential to improve outcomes in pediatric trauma patients.
Purpose of the Study:
- To evaluate the benefits of early percutaneous transcatheter arterial embolization (PTAE) in pediatric patients with blunt abdominal trauma and intra-abdominal bleeding.
- To compare outcomes between early and late embolization strategies.
Main Methods:
- Retrospective analysis of pediatric patients with blunt abdominal trauma and intra-abdominal hemorrhage.
- Comparison of two groups: early embolization (EE) and late embolization (LE).
- Evaluation of intensive care unit (ICU) and hospital length of stay, time to enteral feeding, blood transfusion needs, and costs.
Main Results:
- The EE group had significantly shorter ICU stays (2 days vs. 4 days) and hospital stays (6 days vs. 14 days) compared to the LE group.
- Patients in the EE group required fewer blood transfusions (1 unit vs. 3 units) and incurred lower total hospital costs ($1371.5 vs. $4502).
- Enteral feeding was initiated earlier in the EE group (1 day vs. 4 days).
Conclusions:
- Early PTAE is associated with improved clinical outcomes and reduced healthcare resource utilization in pediatric patients with blunt abdominal trauma.
- Implementing early embolization strategies can lead to shorter recovery times and decreased costs for pediatric trauma patients with intra-abdominal hemorrhage.
Purpose:
Active bleeding due to abdominal trauma is an important cause of mortality in childhood. The aim of this study is to demonstrate the advantages of early percutaneous transcatheter arterial embolization (PTAE) procedures in children with intra-abdominal hemorrhage due to blunt trauma.
Methods:
Children with blunt abdominal trauma were retrospectively included. Two groups were identified for inclusion: patients with early embolization (EE group, n=10) and patients with late embolization (LE group, n=11). Both groups were investigated retrospectively and statistically analyzed with regard to lengths of stay in the intensive care unit and in the hospital, first enteral feeding after trauma, blood transfusion requirements, and cost.
Results:
The duration of stay in the intensive care unit was greater in the LE group than in the EE group (4 days vs. 2 days, respectively). The duration of hospital stay was greater in the LE group than in the EE group (14 days vs. 6 days, respectively). Blood transfusion requirements (15 cc/kg of RBC packs) were greater in the LE group than in the EE group (3 vs. 1, respectively). The total hospital cost was higher in the LE group than in the EE group (4502 USD vs. 1371.5 USD, respectively). The time before starting enteral feeding after first admission was higher in the LE group than in the EE group (4 days vs. 1 day, respectively).
Conclusion:
Early embolization with PTAE results in shorter intensive care and hospitalization stays, earlier enteral feeding, and lower hospital costs for pediatric patients with intra-abdominal hemorrhage due to blunt trauma.
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