Evangelista Meagan E, Gaffley Michaela, Neff Lucas P
General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Pediatric Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
J Blood Med. 2020 May 21;11:163-172. doi: 10.2147/JBM.S205132. eCollection 2020.
In adults, the use of balanced resuscitation and study of massive transfusion protocols have led to improved outcomes for patients and continues to be refined. In children, massive transfusion protocols require further development and study to assess efficacy. Standardization is needed as transfusions and activation of protocols still rely on physician discretion in most pediatric settings. Further research is required to define the pediatric trauma population that will benefit, when to activate these protocols and how to use adjuncts such as tranexamic acid or factor VII in resuscitation. In addition, future implementation of technology such as hemoglobin-based oxygen carriers to increase survival should be studied further in this subset of patients.
在成人中，采用平衡复苏和研究大量输血方案已使患者的治疗效果得到改善，并且该方案仍在不断完善。在儿童中，大量输血方案需要进一步发展和研究以评估其疗效。由于在大多数儿科环境中，输血和启动方案仍依赖医生的判断，因此需要进行标准化。需要进一步研究来确定哪些儿科创伤患者群体将从中受益、何时启动这些方案以及如何在复苏中使用氨甲环酸或凝血因子VII等辅助药物。此外，对于这部分患者，应进一步研究未来实施基于血红蛋白的氧载体等技术以提高生存率的情况。
