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Trauma is a leading cause of death in pediatric patients. The Pediatric Traumatic Hemorrhagic Shock Consensus Conference Recommendations have stated that blood products are better than crystalloid and recommend the use of low titer type O whole blood (LTOWB) over individual components for pediatric traumatic resuscitation.
This study used the Trauma Quality Improvement Program Database to look at 1122 pediatric patients (< 18 years) over a 3 year period to retrospectively examine the impact of the ratio of whole blood and blood products given during the resuscitation of these patients. When at least 30% of the blood products delivered within the first 4 hours of resuscitation were low titer O whole blood, survival improved at the 6, 12 and 24 hour time mark.
The authors concluded that the observed survival benefit supports the greater availability and use of LTOWB during pediatric trauma resuscitation.
References
Fisher AD, April MD, Yazer MH, Wright FL, Cohen MJ, Maqbool B, Getz TM, Braverman MA, Schauer SG. An analysis of the effect of low titer O whole blood (LTOWB) proportions for resuscitation after trauma on 6-hour and 24-hour survival. Am J Surg. 2024 Nov;237:115900. doi: 10.1016/j.amjsurg.2024.115900. Epub 2024 Aug 13. PMID: 39168048.