Pediatric Resuscitative Thoracotomy in Infants, Children, and Early Adolescents: A Scoping Review

Area of Science:

• Emergency Medicine
• Pediatric Surgery
• Trauma Surgery

Background:

• Resuscitative thoracotomy (RT) is a critical intervention in trauma care.
• Limited data exists on the efficacy and indications of RT specifically in the pediatric population, especially in infants and young children.
• Existing literature often aggregates pediatric and adult outcomes, hindering specific analysis.

Purpose of the Study:

• To characterize the presentation and outcomes of pediatric patients (≤15 years) undergoing resuscitative thoracotomy.
• To identify gaps in current literature regarding pediatric RT, particularly for younger age groups.
• To propose a preliminary reporting checklist to enhance data granularity and consistency in pediatric RT studies.

Main Methods:

• A comprehensive scoping review of publications in PubMed, Embase, and Scopus up to March 2024.
• Inclusion criteria focused on studies reporting outcomes of patients ≤15 years undergoing RT for traumatic injury.
• Data extraction included mechanism of injury, presentation, procedure details, and survival rates.

Main Results:

• 26 articles were included, reporting on 459 pediatric patients who underwent RT, with an overall survival rate of 17.6% (81 survivors).
• Significant variability in age reporting was noted, with many studies lacking precise age data.
• Among survivors with known ages, a higher proportion were in the older pediatric age groups (10-15 years).

Conclusions:

• The utility and indications for pediatric RT in young children and infants remain understudied.
• Current literature suffers from inconsistent reporting and insufficient data granularity, impeding evidence-based protocol development.
• Establishing universal reporting guidelines and a standardized checklist is crucial for improving data sharing and advancing pediatric RT research.