Association of Blood Component Ratios With 24-Hour Mortality in Injured Children Receiving Massive Transfusion

Objectives: To determine if higher fresh frozen plasma and platelet to packed RBC ratios are associated with lower 24-hour mortality in bleeding pediatric trauma patients. Design: Retrospective cohort study using the Pediatric Trauma Quality Improvement Program Database from 2014 to 2016. Setting: Level 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. Interventions: None. Measurements and Main Results: Ratios 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
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research