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Changes in transfusion and fluid therapy practices in severely injured children: an analysis of 5118 children from the TraumaRegister DGU®
- Purpose: 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. Methods: 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. Results: 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. Conclusion: 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.
Verfasserangaben: | Florian PiekarskiORCiDGND, Jost KaufmannORCiDGND, Thomas EngelhardtGND, Florian RaimannORCiDGND, Thomas LustenbergerORCiDGND, Ingo MarziORCiDGND, Rolf LeferingORCiDGND, Kai ZacharowskiORCiDGND, Patrick MeybohmORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-694478 |
DOI: | https://doi.org/10.1007/s00068-020-01423-z |
ISSN: | 1863-9941 |
Titel des übergeordneten Werkes (Englisch): | European journal of trauma and emergency surgery |
Verlag: | Springer Medizin |
Verlagsort: | Heidelberg |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Datum der Veröffentlichung (online): | 29.06.2020 |
Datum der Erstveröffentlichung: | 29.06.2020 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Beteiligte Körperschaft: | TraumaRegister DGU |
Datum der Freischaltung: | 06.03.2023 |
Freies Schlagwort / Tag: | Fluid therapy; Mortality; Outcome; Paediatric trauma patients; Patient blood management; Serious injured children; Transfusion practice; TraumaRegister DGU® (TR-DGU); Volume therapy |
Jahrgang: | 48 |
Ausgabe / Heft: | 1 |
Seitenzahl: | 9 |
Erste Seite: | 373 |
Letzte Seite: | 381 |
HeBIS-PPN: | 508512956 |
Institute: | Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | Creative Commons - CC BY - Namensnennung 4.0 International |