Related Experiment Video

Updated: Nov 24, 2025

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock
09:09

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock

Published on: November 3, 2023

1.3K

Elevated pediatric age-adjusted shock-index (SIPA) in blunt solid organ injuries

Ryan Phillips1, Maxene Meier2, Niti Shahi1

  • 1Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, USA; Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Journal of Pediatric Surgery
|December 28, 2020
PubMed

Insights

An elevated pediatric age-adjusted shock index (SIPA) in pre-hospital or ED settings accurately identifies children with blunt liver or spleen injury (BLSI) who may require blood transfusion or surgery. This finding aids in early risk stratification for pediatric trauma patients.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Pediatric Critical Care

Background:

  • The pediatric age-adjusted shock index (SIPA) is established for predicting outcomes in pediatric blunt trauma.
  • Early identification of children with blunt liver or spleen injury (BLSI) is crucial for appropriate management.

Purpose of the Study:

  • To investigate if an elevated SIPA score in pre-hospital or emergency department (ED) settings can identify children with BLSI.
  • To determine if elevated SIPA is associated with the need for blood transfusion or failure of non-operative management (NOM).

Main Methods:

  • Retrospective analysis of pediatric patients (1-18 years) with BLSI from the ACS pediatric-TQIP database (2014-2016).
  • Patients were stratified based on the requirement for blood transfusion and/or abdominal operation.
  • Multivariable regression was used to assess the association between SIPA and clinical outcomes.

Main Results:

  • A total of 3561 patients with BLSI were analyzed; 4% received blood transfusions and 4% underwent surgery.
  • Patients needing blood transfusion or failing NOM had significantly higher Injury Severity Scores (ISS) and mortality.
  • An elevated pre-hospital or ED SIPA was strongly associated with the need for blood transfusion (OR 8.2) and failure of NOM (OR 2.3).

Conclusions:

  • Elevated SIPA in pre-hospital or ED settings is a reliable indicator of hemodynamic instability in children with BLSI.
  • SIPA effectively identifies pediatric patients with BLSI who are at higher risk for requiring blood products or surgical intervention.
  • This tool can aid clinicians in early risk stratification and management decisions for pediatric blunt abdominal trauma.
Abstract

Keywords:
ChildrenPediatric traumaSIPASolid organ injury

More Related Videos

Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research08:14

Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research

Published on: March 22, 2024

1.8K
Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock07:48

Noninvasive and Invasive Renal Hypoxia Monitoring in a Porcine Model of Hemorrhagic Shock

Published on: October 28, 2022

1.4K

Related Concept Videos

Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
1.2K
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
464
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
567
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
300
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
145
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
109