@article{ref1,
title="Thrombelastography and transfusion patterns in severely injured pediatric trauma patients with blunt solid organ injuries",
journal="Journal of trauma and acute care surgery",
year="2021",
author="Stevens, Jenny and Pickett, Kaci and Moore, Hunter and Reppucci, Marina L. and Phillips, Ryan and Moulton, Steven and Bensard, Denis",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Thrombelastography (TEG) has emerged as a useful tool to diagnose coagulopathy and guide blood product usage during trauma resuscitations. This study sought to evaluate the correlation between TEG-directed blood product administration in severely injured pediatric trauma patients with blunt solid organ injuries (BSOI). <br><br>METHODS: Patients (<18 years) with severe BSOI who presented as highest-level trauma activations at two pediatric trauma centers (PTC) were included. TEG results were evaluated to determine indications for blood product administration and rates of TEG-directed resuscitation. Tetrachoric correlations and regression modeling were used to correlate TEG-directed resuscitation with clinical outcomes. <br><br>RESULTS: Of 64 patients who met inclusion criteria, 32.8% (21) had elevated R-times and 23.4% (15) had shortened alpha-angles. MA was shortened in 29.7% (19) and LY30 > 3% was seen in 17.0% (9). TEG-directed resuscitation of FFP was followed 54.7% of the time compared to 67.2% and 81.2% for platelets and cryoprecipitate, respectively. TEG-directed resuscitation with platelets (OR 0.56, 95% CI, 0.33, 0.93, p = 0.03) and/or cryoprecipitate (OR 0.09, 95% CI, 0.01, 0.42, p = 0.003) were associated with decreased hospital length of stay and mortality, respectively. <br><br>CONCLUSION: Severely injured pediatric trauma patients with BSOI were often coagulopathic upon presentation to the Emergency Department. TEG-directed resuscitation with platelets and/or cryoprecipitate was followed for the majority of patients and was associated with improved outcomes. LEVEL OF EVIDENCE/TYPE OF STUDY: Level III, retrospective comparative study.<p /> <p>Language: en</p>",
language="en",
issn="2163-0755",
doi="10.1097/TA.0000000000003392",
url="http://dx.doi.org/10.1097/TA.0000000000003392"
}