Blood product use in paediatric trauma: lessons from the TARN data

Area of Science:

• Pediatric Trauma Care
• Hemorrhagic Shock Management
• Blood Product Transfusion Practices

Background:

• Childhood trauma leads to significant morbidity and mortality, with uncontrolled hemorrhage being a primary cause of preventable death.
• Growing evidence supports early identification of pediatric trauma patients needing blood products.
• Damage control resuscitation and risk prediction tools may influence recent transfusion practices.

Purpose of the Study:

• To identify trends in blood product prescribing practices for pediatric trauma resuscitation over a decade (2012-2021).
• To analyze changes in blood product use in relation to patient demographics and injury types.

Main Methods:

• Retrospective observational study using data from the Trauma Audit Research Network (TARN).
• Included injured children (<16 years) receiving blood products, including prehospital administration.
• Data collected from sites in England, Wales, and Northern Ireland (2012-2021).

Main Results:

• 2.5% of injured children received blood products within 24 hours; overall administration remained unchanged (p=0.190).
• Increased blood product use observed in older children and those with penetrating injuries (p<0.03).
• Decreased use in road traffic collision-related trauma (p=0.01); packed red blood cells were most common (84%).

Conclusions:

• UK trauma centers have not significantly altered blood product use in pediatric trauma over the last decade.
• Monitoring national blood product use is crucial for understanding trends and current practices in pediatric trauma resuscitation.