Related Experiment Video
Updated: Aug 23, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Outcomes in Pediatric Trauma Patients Who Receive Blood Transfusion
Marina L Reppucci1, Kaci Pickett2, Jenny Stevens1
1Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado; Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Insights
Massive transfusion (MT) in pediatric trauma patients is linked to higher rates of deep venous thrombosis, acute kidney injury, and sepsis. These adverse outcomes were observed regardless of patient age.
Area of Science:
- Trauma Care
- Pediatric Critical Care
- Transfusion Medicine
Background:
- Massive transfusion (MT) in pediatric trauma patients is associated with adverse outcomes.
- Understanding these risks is crucial for optimizing patient care.
Purpose of the Study:
- To assess the association between MT and outcomes in pediatric trauma patients.
- To determine if age influences MT-associated outcomes.
Main Methods:
- Utilized the ACS TQIP database (2015-2018) for pediatric patients (1-18 years) receiving blood.
- Defined MT as ≥40 mL/kg blood products within 24 hours; patients were propensity score matched.
- Performed adjusted logistic regression to analyze outcomes.
Main Results:
- MT patients showed higher incidence of deep venous thrombosis (DVT), acute kidney injury (AKI), CLABSI, and severe sepsis.
- MT was an independent risk factor for these adverse events.
- No significant age-based differences in MT-associated outcomes were found.
Conclusions:
- While overall transfusion outcomes are low, MT increases risks for DVT, AKI, CLABSI, and sepsis in pediatric trauma.
- Age did not modify the risk of these outcomes following MT.
Introduction:
Increased blood volumes, due to massive transfusion (MT), are known to be associated with both infectious and noninfectious adverse outcomes. The aim of this study was to assess the association between MT and outcomes in pediatric trauma patients, and, secondarily, determine if these outcomes are differential by age once MT is reached.
Methods:
Pediatric patients (ages 1-18 y old) in the ACS pediatric Trauma Quality Improvement Program (TQIP) database (2015-2018) who received blood were included. Patients were stratified by MT status, which was defined as blood product volume of 40 mL/kg within 24 h of admission (MT+) and compared to children who received blood products but did not meet the MT threshold (MT-). Defined MT + patients were matched 1:1 to MT-patients via propensity score matching of characteristics before comparisons. Adjusted logistic regression was performed on univariably significant outcomes of interest.
Results:
There were 2318 patients in the analytic cohort. Patients who received MT had higher rates of deep venous thrombosis (DVT) (2.5% versus 1.0%, P < 0.001), acute kidney injury (AKI) (1.5% versus 0.0%, P = 0.022), CLABSI (4.0% versus 2.0% P = 0.008), and severe sepsis (2.3% versus. 1.1%, P = 0.02). On logistic regression MT was an independent risk factor for these outcomes. There was no differential effect of MT on these outcomes based on age.
Conclusions:
Outcomes associated with blood transfusion in pediatric trauma patients are low overall, but rates of DVT, AKI, CLABSI, and sepsis are higher in those who receive MT+ with no differences based on age.
Related Concept Videos
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:26Kidney Transplant II: Surgical Procedure
01:20Extrinsic and Intrinsic Pathways of Hemostasis
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...