在部署的美国军事治疗设施中的儿童死亡率:2001-2022年
Sara E Bibbens1, Jonathan D Stallings2, Monica L Casmaer3
1Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Pediatrics
|March 9, 2026
概括
冲突地区的儿童死亡率很高,年幼的儿童和烧伤伤与死亡人数的增加有关. 在非幸存者中,较大的血液损失和不充分的输血支持凸显了改善出血控制和儿科特异性创伤协议的需要.
科学领域:
- 儿科创伤研究儿童创伤研究.
- 冲突医学是一种冲突医学.
- 伤害的流行病学.
背景情况:
- 儿童因冲突伤害的死亡率是一个重大问题,需要对伤害模式和结果有更深入的了解.
- 在冲突地区为儿科护理提供有效的资源分配和培训取决于可靠的数据.
研究的目的:
- 描述冲突地区的儿科伤害.
- 检查儿童冲突伤亡者受伤模式,资源可用性和生存率之间的关系.
- 确定在严酷的冲突相关环境中导致儿童死亡的因素.
主要方法:
- 美国国防部创伤登记处 (2001-2022) 的回顾性队列分析.
- 纳入标准:儿童 (<18岁) 在冲突地区的军事治疗设施接受治疗,有记录的受伤和退役状态.
- 主要结局:存活到出院.
主要成果:
- 总共分析了5695名儿童,总死亡率为9.4%.
- 不幸存者比幸存者更年轻,受伤严重程度得分更高,并与幸存者相比遭受更多的烧伤伤害.
- 没有幸存者经历了显著更大的血液损失,需要更多的输血,在两组中,红细胞与血小板的比例都不够理想.
结论:
- 这项研究揭示了特定年龄的受伤模式和复苏要求,这些因素有助于冲突地区的儿童死亡率.
- 不幸存者的血液流失和复苏量增加强调了早期出血控制的关键需求.
- 研究结果支持实施标准化儿科设备,针对性培训出血性休克管理,并为冲突环境中的儿科患者量身定制的协议.
相关概念视频
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
345
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
345
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
411
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
411
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
306
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
306
01:29Drug Dosing: Infants and Children
645
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
645
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
605
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
605
01:26Pharmaceutical Poisoning: Potential Scenarios
53
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
53