Ramos-Jimenez Rafael G, Leeper Christine
Department of Surgery, UPMC Presbyterian Shadyside, Pittsburgh, PA, USA.
Department of Surgery, UPMC Presbyterian Shadyside, Pittsburgh, PA, USA; University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Transfus Med Rev. 2021 Oct;35(4):113-117. doi: 10.1016/j.tmrv.2021.06.008. Epub 2021 Aug 26.
Trauma is a major source of morbidity and mortality for children worldwide; life-threatening hemorrhage is a primary cause of preventable death. Essential interventions in children with life-threatening hemorrhage include hemostatic resuscitation and mechanical control of bleeding. Herein we review pediatric hemostatic resuscitation, a strategy that addresses both hemorrhagic shock and the coagulopathic complications described in patients with major hemorrhage. Some components of hemostatic resuscitation may include: early and aggressive resuscitation with blood products, minimizing crystalloid and hemodilution, antifibrinolytic adjuncts such as tranexamic acid, and the novel use of low-titer group O whole-blood (LTOWB) transfusion in injured children. The following selection of important publications address the current state of hemostatic resuscitation strategies in pediatric trauma patients as well as the remaining knowledge gaps and areas for further research.
创伤是全球儿童发病和死亡的主要原因；危及生命的出血是可预防死亡的主要原因。对有危及生命出血的儿童进行的基本干预措施包括止血复苏和出血的机械控制。在此，我们回顾儿科止血复苏，这是一种应对出血性休克和大出血患者中所述凝血病并发症的策略。止血复苏的一些组成部分可能包括：早期积极输注血液制品进行复苏、尽量减少晶体液使用和血液稀释、使用抗纤溶辅助药物如氨甲环酸，以及在受伤儿童中创新性地使用低滴度O型全血（LTOWB）输血。以下精选的重要出版物阐述了儿科创伤患者止血复苏策略的现状以及尚存的知识空白和进一步研究的领域。
