Transfusion · 2026
Whole blood resuscitation and post-traumatic organ dysfunction in injured children.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Feeney Erin V, Scarmack Madelyn A, Furman Leah M, Spinella Philip C, Kalinowski Anne H, Horvat Christopher M, Gaines Barbara A, Leeper Christine M
Аннотация
BACKGROUND: Both whole blood (WB) and component therapy (CT) are used for hemostatic resuscitation in injured children. We hypothesize that early WB transfusion compared to CT alone is associated with decreased post-traumatic organ dysfunction.
STUDY DESIGN AND METHODS: This single-center observational study included children ages 0-17 years between January 2021 and March 2024 with trauma mechanism and intensive care unit admission. The primary outcome was Pediatric Logistic Organ Dysfunction 2 (PELOD-2) score on post-trauma days 1-7. Data were analyzed using linear regression adjusting for age, sex, race, year, injury mechanism, injury severity score (ISS), shock index pediatric age-adjusted, and total 4-h transfusion volume (mL/kg).
RESULTS: In total, 540 subjects met eligibility criteria; of the 52/540 (10%) who received blood transfusion within 4 h, 11/52 (21%) received RBC alone, 12/52 (23%) received WB alone, 9/52 (17%) of subjects received RBC plus other, and 20/52 (38%) received WB plus other. The cohort was 60% (326/540) male, 83% (449/540) blunt injury mechanism, median (interquartile range [IQR]) age 3 years (0-11), and median (IQR) ISS of 11 (8-18). In adjusted analysis, transfusion of WB + other was an independent predictor of lower PELOD-2 score through post-trauma day 7 in comparison to subjects receiving RBC + other.
DISCUSSION: In subjects who were transfused multiple blood products, receipt of any WB versus CT alone for hemostatic resuscitation after injury was associated with reduced organ dysfunction. Further investigation is needed in large cohorts to fully elucidate clinical benefit and improve mechanistic understanding.
STUDY DESIGN AND METHODS: This single-center observational study included children ages 0-17 years between January 2021 and March 2024 with trauma mechanism and intensive care unit admission. The primary outcome was Pediatric Logistic Organ Dysfunction 2 (PELOD-2) score on post-trauma days 1-7. Data were analyzed using linear regression adjusting for age, sex, race, year, injury mechanism, injury severity score (ISS), shock index pediatric age-adjusted, and total 4-h transfusion volume (mL/kg).
RESULTS: In total, 540 subjects met eligibility criteria; of the 52/540 (10%) who received blood transfusion within 4 h, 11/52 (21%) received RBC alone, 12/52 (23%) received WB alone, 9/52 (17%) of subjects received RBC plus other, and 20/52 (38%) received WB plus other. The cohort was 60% (326/540) male, 83% (449/540) blunt injury mechanism, median (interquartile range [IQR]) age 3 years (0-11), and median (IQR) ISS of 11 (8-18). In adjusted analysis, transfusion of WB + other was an independent predictor of lower PELOD-2 score through post-trauma day 7 in comparison to subjects receiving RBC + other.
DISCUSSION: In subjects who were transfused multiple blood products, receipt of any WB versus CT alone for hemostatic resuscitation after injury was associated with reduced organ dysfunction. Further investigation is needed in large cohorts to fully elucidate clinical benefit and improve mechanistic understanding.