Changes in transfusion and fluid therapy practices in severely injured children: an analysis of 5118 children from the TraumaRegister DGU®.
Fluid therapy
Mortality
Outcome
Paediatric trauma patients
Patient blood management
Serious injured children
Transfusion practice
TraumaRegister DGU® (TR-DGU)
Volume therapy
Journal
European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
13
05
2020
accepted:
19
06
2020
pubmed:
1
7
2020
medline:
11
2
2022
entrez:
1
7
2020
Statut:
ppublish
Résumé
Trauma is the leading cause of death in children. In adults, blood transfusion and fluid resuscitation protocols changed resulting in a decrease of morbidity and mortality over the past 2 decades. Here, transfusion and fluid resuscitation practices were analysed in severe injured children in Germany. Severely injured children (maximum Abbreviated Injury Scale (AIS) ≥ 3) admitted to a certified trauma-centre (TraumaZentrum DGU®) between 2002 and 2017 and registered at the TraumaRegister DGU® were included and assessed regarding blood transfusion rates and fluid therapy. 5,118 children (aged 1-15 years) with a mean ISS 22 were analysed. Blood transfusion rates administered until ICU admission decreased from 18% (2002-2005) to 7% (2014-2017). Children who are transfused are increasingly seriously injured. ISS has increased for transfused children aged 1-15 years (2002-2005: mean 27.7-34.4 in 2014-2017). ISS in non-transfused children has decreased in children aged 1-15 years (2002-2005: mean 19.6 to mean 17.6 in 2014-2017). Mean prehospital fluid administration decreased from 980 to 549 ml without affecting hemodynamic instability. Blood transfusion rates and amount of fluid resuscitation decreased in severe injured children over a 16-year period in Germany. Restrictive blood transfusion and fluid management has become common practice in severe injured children. A prehospital restrictive fluid management strategy in severely injured children is not associated with a worsened hemodynamic state, abnormal coagulation or base excess but leads to higher hemoglobin levels.
Identifiants
pubmed: 32601717
doi: 10.1007/s00068-020-01423-z
pii: 10.1007/s00068-020-01423-z
pmc: PMC8825567
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
373-381Informations de copyright
© 2020. The Author(s).
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