Whole blood transfusion in pediatric trauma patients with traumatic brain injury may decrease the risk of early death

Area of Science:

• Trauma Resuscitation
• Pediatric Critical Care
• Neurotrauma

Background:

• Whole blood is increasingly used for trauma resuscitation.
• Outcomes for pediatric trauma patients with TBI receiving whole blood are not well-established.
• Component blood therapy is the traditional approach.

Purpose of the Study:

• To investigate the association between whole blood resuscitation and mortality/complications in pediatric trauma patients with TBI.
• To compare outcomes of whole blood versus component blood therapy in this population.

Main Methods:

• Analysis of the 2020-2021 TQIP database.
• Inclusion of pediatric trauma patients (≤17 years) with TBI requiring blood resuscitation.
• Multivariable analysis to assess risks of mortality and complications.

Main Results:

• 11% of 1740 patients received whole blood.
• Whole blood and component therapy groups had similar overall mortality and complication rates.
• Whole blood resuscitation was associated with a significantly lower risk of early mortality (within 24 hours).

Conclusions:

• Whole blood use in pediatric TBI trauma is low but associated with reduced early mortality.
• No significant difference in overall mortality or complications was observed.
• Prospective studies are required to validate these findings and guide clinical practice.