Lab Med Online.  2016 Apr;6(2):60-63. 10.3343/lmo.2016.6.2.60.

Massive Transfusion Protocols for Pediatric Patients

• Lee HT
• Park PW
• Seo YH
• Ahn JY
• Seo JY
• Jeong JH
• Kim MJ
• Lee JN
• Lee GJ
• Kim KH

• KMID: 2160085
• DOI: http://doi.org/10.3343/lmo.2016.6.2.60

Abstract

The number of massive transfusions for pediatric patients has risen owing to the increasing number of complex surgeries and trauma centers. However, as there are only a few studies on pediatric massive transfusion, adult massive transfusion protocols are used for pediatric patients in many hospitals and institutions. Although massive transfusion protocols would improve the outcomes and reduce the received blood products during transfusion, pediatric patients differ from adults in the tolerability to transfusion, incidence of coagulopathy, and mechanisms of injuries. Therefore clinical physicians have requested for a pediatric massive transfusion protocol. Herein, we reviewed pediatric massive transfusion protocols that have been used in various clinical settings. To date, only a few single-center studies with a small number of pediatric patients have been performed. Even though these studies did not show improvement in outcomes such as mortality and side effects, they reported a short preparation time for fresh frozen plasma products and a low coagulopathy rate in pediatric massive transfusion groups. Therefore, large, prospective, multicenter studies are needed to identify the empiric ratio of blood products for improving outcomes of pediatric patients who need massive transfusion.

Keyword

Pediatric; Massive transfusion protocol; Coagulopathy

MeSH Terms

Adult
Humans
Incidence
Mortality
Plasma
Prospective Studies
Trauma Centers

Figure

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  Fig. 1 Size-adjusted packages for the pediatric trauma massive transfusion protocol, as described by Hendrickson et al. *unit; †apheresis.

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