ArticleCritical care medicine2019
Association of Blood Component Ratios With 24-Hour Mortality in Injured Children Receiving Massive Transfusion.
Article in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Research Priorities for Plasma and Platelet Transfusion Strategies in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2022Pooled it
- Time-limited association between plasma transfusion and mortality in pediatric traumatic brain injury.The journal of trauma and acute care surgery · 2025Article
- Patient sex and outcomes in children with life-threatening hemorrhage.Transfusion · 2024Observational
- Canadian tertiary care pediatric massive hemorrhage protocols: a survey and comprehensive national review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Blood Product Transfusions for Children in the Perioperative Period and for Critically Ill Children.Deutsches Arzteblatt international · 2024Review
- Use of whole blood in pediatric trauma: a narrative review.Trauma surgery & acute care open · 2024Review
- Association between the plasma-to-red blood cell ratio and survival in geriatric and non-geriatric trauma patients undergoing massive transfusion: a retrospective cohort study.Journal of intensive care · 2022Article
- Effect of Massive Transfusion Protocol on Coagulation Function in Elderly Patients with Multiple Injuries.Computational and mathematical methods in medicine · 2021Article
- Open-chest versus closed-chest cardiopulmonary resuscitation in trauma patients with signs of life upon hospital arrival: a retrospective multicenter study.Critical care (London, England) · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesTo determine if higher fresh frozen plasma and platelet to packed RBC ratios are associated with lower 24-hour mortality in bleeding pediatric trauma patients.
designRetrospective cohort study using the Pediatric Trauma Quality Improvement Program Database from 2014 to 2016.
settingLevel I and II pediatric trauma centers participating in the Trauma Quality Improvement Program PATIENTS:: Injured children (≤ 14 yr old) who received massive transfusion (≥ 40 mL/kg total blood products in 24 hr). Of 123,836 patients, 590 underwent massive transfusion, of which 583 met inclusion criteria.
interventionsNone. MEASUREMENTS AND MAIN
resultsRatios of fresh frozen plasma:packed RBC and platelet:packed RBC. Of the 583 patients, 60% were male and the median age was 5 years (interquartile range, 2-10 yr). Overall mortality was 19.7% (95% CI, 16.6-23.2%) at 24 hours. There was 51% (adjusted relative risk, 0.49; 95% CI, 0.27-0.87; p = 0.02) and 40% (adjusted relative risk, 0.60; 95% CI, 0.39-0.92; p = 0.02) lower risk of death at 24 hours for the high (≥ 1:1) and medium (≥ 1:2 and < 1:1) fresh frozen plasma:packed RBC ratio groups, respectively, compared with the low ratio group (< 1:2). Platelet:packed RBC ratio was not associated with mortality (adjusted relative risk, 0.94; 95% CI, 0.51-1.71; p = 0.83).
conclusionsHigher fresh frozen plasma ratios were associated with lower 24-hour mortality in massively transfused pediatric trauma patients. The platelet ratio was not associated with mortality. Although these findings represent the largest study evaluating blood product ratios in pediatric trauma patients, prospective studies are necessary to determine the optimum blood product ratios to minimize mortality in this population.
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