A prospective review of transfusion practices in paediatric trauma patients at level 1 trauma centre

Area of Science:

• Pediatric Emergency Medicine
• Trauma Surgery
• Transfusion Medicine

Background:

• Pediatric trauma transfusion practices often rely on adult protocols, overlooking physiological and injury differences.
• Current transfusion strategies in pediatric trauma require evaluation to guide management and research.
• Understanding transfusion needs in pediatric trauma is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate current transfusion practices in pediatric trauma patients.
• To identify factors associated with transfusion requirements in this population.
• To inform clinical management, research, and resource planning for pediatric trauma care.

Main Methods:

• Prospective observational study over one year.
• Inclusion of trauma patients under 18 years receiving transfusions.
• Data collection on demographics, injury details, transfusion specifics, and outcomes, with descriptive and associative analyses.

Main Results:

• 38.7% of pediatric trauma patients received transfusions, predominantly packed red blood cells (PRBC), fresh frozen plasma (FFP), and rapid defrosted plasma (RDP).
• Transfusion requirements varied, with median PRBC at 21.8 ml/kg, FFP at 17.5 ml/kg, and RDP at 5.8 ml/kg.
• Early PRBC transfusion linked to lower hemoglobin and tachycardia; RDP/FFP associated with higher injury severity and shock indicators. Massive transfusion (≥40 ml/kg/24h) occurred in 25.9% of cases.

Conclusions:

• A significant proportion of pediatric trauma patients require transfusions, particularly plasma and platelets for severe hemorrhage.
• Transfusion necessity is correlated with injury severity and clinical parameters.
• Timely and tailored transfusion strategies are essential for improving outcomes in pediatric trauma patients.