Massive Transfusion in Pediatric Patients

Lucas P Neff¹, Michael Aaron Beckwith², Robert T Russell³, Jeremy W Cannon⁴, Philip C Spinella⁵

Affiliations

¹ Department of General Surgery, Section of Pediatric Surgery, Wake Forest University School of Medicine, 5th Floor, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: lpneff@wakehealth.edu.
² Division of Trauma and Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Avenue South, KB 120, Birmingham, AL 35294, USA.
³ Pediatric General Surgery, Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder, Suite 300, Birmingham, AL 35233, USA.
⁴ Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Penn Presbyterian Medical Center, 51 North 39th Street, Suite 120 MOB, Philadelphia, PA 19104, USA.
⁵ Division of Critical Care Medicine, Department of Pediatrics, The Washington University of Saint Louis, 4905 Children's Place, St Louis, MO 63110, USA.

PMID: 33494884
DOI: 10.1016/j.cll.2020.10.003

Review

Massive Transfusion in Pediatric Patients

Lucas P Neff et al. Clin Lab Med. 2021 Mar.

. 2021 Mar;41(1):35-49.

doi: 10.1016/j.cll.2020.10.003. Epub 2020 Dec 15.

Authors

Lucas P Neff¹, Michael Aaron Beckwith², Robert T Russell³, Jeremy W Cannon⁴, Philip C Spinella⁵

Affiliations

¹ Department of General Surgery, Section of Pediatric Surgery, Wake Forest University School of Medicine, 5th Floor, Watlington Hall, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Electronic address: lpneff@wakehealth.edu.
² Division of Trauma and Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, 1922 7th Avenue South, KB 120, Birmingham, AL 35294, USA.
³ Pediatric General Surgery, Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder, Suite 300, Birmingham, AL 35233, USA.
⁴ Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Penn Presbyterian Medical Center, 51 North 39th Street, Suite 120 MOB, Philadelphia, PA 19104, USA.
⁵ Division of Critical Care Medicine, Department of Pediatrics, The Washington University of Saint Louis, 4905 Children's Place, St Louis, MO 63110, USA.

PMID: 33494884
DOI: 10.1016/j.cll.2020.10.003

Abstract

Massive transfusion in pediatric patients is infrequent but associated with much higher mortality than in adults. Blood transfusion and hematology has conceptualized ideas such as blood failure and the interplay of the blood-endothelium interface to understand coagulopathy in the context of hemorrhagic shock. Researchers are still searching for an appropriate definition of what constitutes a pediatric massive transfusion. There is no universally accepted protocol for massive transfusion and how to address the many complications that can arise. Pharmacologic adjuncts to resuscitation may prove beneficial in reducing coagulopathy during pediatric massive transfusion, but high-quality evidence has not yet emerged.

Keywords: Blood failure; Endotheliopathy; Hemorrhage; Pediatric massive transfusion; Whole blood.

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Conflict of interest statement

Disclosure P.C. Spinella: consultant for Secure Transfusion Services, Cerus, and Octapharma. J.W. Cannon: DOD funding on resuscitation/decision support, UpToDate royalties on REBOA (resuscitative endovascular balloon occlusion of the aorta). The other authors have nothing to disclose.

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Massive Transfusion in Pediatric Patients

Affiliations

Massive Transfusion in Pediatric Patients

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical