By Jay Lewis, AABB Communications Staff
Transfusion with whole blood is an appropriate therapeutic option when treating pediatric patients who have lost blood due to a traumatic injury, according to new research from the U.S. Department of Defense (DoD). The research was presented during an Oral Abstract Session on Pediatrics and Obstetrics by Andrew Fisher, MD, resident physician at the University of New Mexico School of Medicine, during the AABB 2020 Virtual Annual Meeting and posted on the association's blog.
Fisher and his colleagues conducted their study to learn more about optimal treatment options for pediatric patients with traumatic injuries. Fisher noted that studies examining transfusion in adult trauma patients have shown better outcomes when a balanced approach to blood component resuscitation was used. “More recent developments demonstrate that whole blood therapy… may be beneficial,” Fisher said. “Additionally, whole blood is easier to administer and only requires one storage medium.”
Fisher acknowledged that there has been limited research examining this issue in pediatric patients. “It remains unclear whether there is potential benefit in the pediatric population,” he said. To begin to address this, the researchers examined data from the Department of Defense (DoD) Trauma Registry for information on pediatric patients who underwent massive transfusion at U.S. and coalition hospitals in Iraq or Afghanistan between January 2007 and January 2016.
A total of 543 patients were included in the analysis. Of these, 23 received whole blood; 18 of this subgroup met the definition of massive transfusion without a serious head injury. Among the patients who underwent massive transfusion, there was no significant difference in survival between whole blood recipients and those who did not receive whole blood.
Fisher said the results that in pediatric trauma patients, “survival is no worse when using whole blood.” He added that when adjusting for additional factors, whole blood was associated with higher survival rates. More data is still needed to better understand the effects of whole blood in pediatric trauma patients. “In order to move forward and truly assess the effects of whole blood in the pediatric population, prospective studies are critically needed,” Fisher said.
