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The risk factors of plasma transfusions during resuscitation in pediatric burn patients: a retrospective study from
Liqiang Zhu1, Xiaorong Zhang2, Xingcun Wang2
1Department of Quality Management, The Central Theatre Air Force Hospital of the Chinese People's Liberation Army, Datong, Shanxi, China.
Insights
Plasma transfusions are given to 12.89% of pediatric burn patients. Total body surface area (TBSA), white blood cell count (WBC), heart rate, and pre-hospital remedies predict transfusion needs.
Area of Science:
- Pediatric Burn Care
- Resuscitation Medicine
- Transfusion Medicine
Background:
- Burn resuscitation is critical for pediatric patients.
- Plasma transfusions are a key component of burn resuscitation.
- Identifying predictors for plasma transfusion is essential for optimal patient management.
Purpose of the Study:
- To determine the prevalence of plasma transfusions in pediatric burn patients.
- To identify risk factors associated with plasma transfusion during burn resuscitation.
Main Methods:
- Retrospective study at a Chinese burn treatment center (2010-2021).
- Included pediatric patients (2 months to 14 years) admitted for burns.
- Non-conditional logistic regression used to evaluate risk factors for plasma transfusion.
Main Results:
- 12.89% of pediatric burn patients received plasma transfusions.
- Significant predictors for plasma transfusion included total body surface area (TBSA), white blood cell count (WBC), heart rate, and pre-hospital remedies.
- Patients receiving transfusions often had delayed admission (>6 hours) or no pre-hospital treatment.
Conclusions:
- TBSA, WBC, heart rate, and pre-hospital interventions are reliable predictors for plasma transfusion necessity in pediatric burn resuscitation.
- These predictors can aid in targeted plasma administration and potentially reduce overall transfusion requirements.
- Optimizing plasma transfusion strategies improves outcomes for pediatric burn patients.
Objectives:
To analyze the prevalence and risk factors of plasma transfusions during resuscitation after burns in children.
Methods:
A retrospective study was carried out at the Burn Treatment Center of the Central Theatre Air Force Hospital of the People's Liberation Army in Datong City, China. The study included pediatric patients (between the ages of two months and 14 years) who were admitted for burns between January 2010 and December 2021. Details of plasma transfusions during the burn resuscitation process for each child were recorded. The association between risk factors and plasma transfusions was evaluated using non-conditional logistic regression.
Results:
Of the children who suffered from burns, 12.89% (n = 174/1,350) received plasma transfusions during burn resuscitation. The median amount of plasma transfusions administered was 2.5 units (interquartile range, 1.4). Among the pediatric burn patients who received plasma transfusion, 67.24% did not receive any treatments before being admitted to the hospital, while 14.94% were admitted 6 h or more after the burns occurred. The total body surface area (TBSA) of pediatric burn patients who received plasma transfusion ranged from 10% to 55%, with a median burn area of 20% of the TBSA and a mean burn area of 22% of the TBSA. Non-conditional logistic regression analysis identified TBSA, white blood cell count (WBC), heart rate, and pre-hospital remedies as significant predictors of plasma transfusion.
Conclusion:
TBSA (total body surface area), WBC (white blood cell count), heart rate, and pre-hospital interventions can serve as reliable predictors for determining the necessity of plasma transfusions during burn resuscitation. Utilizing these factors can assist blood banks and clinicians in preparing and administering targeted plasma treatments, as well as potentially reducing the overall need for plasma transfusions in pediatric burn patients.
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