Pediatric traumatic hemorrhagic shock consensus conference recommendations

Robert T. Russell, Joseph R. Esparaz, Michael A. Beckwith, Peter J. Abraham, Melania M. Bembea, Matthew A. Borgman, Randall S. Burd, Barbara A. Gaines, Mubeen Jafri, Cassandra D. Josephson, Christine Leeper, Julie C. Leonard, Jennifer A. Muszynski, Kathleen K. Nicol, Daniel K. Nishijima, Paul A. Stricker, Adam M. Vogel, Trisha E. Wong, Philip C. Spinella

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Hemorrhagic shock in pediatric trauma patients remains a challenging yet preventable cause of death. There is little high-quality evidence available to guide specific aspects of hemorrhage control and specific resuscitation practices in this population. We sought to generate clinical recommendations, expert consensus, and good practice statements to aid providers in care for these difficult patients. The Pediatric Traumatic Hemorrhagic Shock Consensus Conference process included systematic reviews related to six subtopics and one consensus meeting. A panel of 16 consensus multidisciplinary committee members evaluated the literature related to 6 specific topics: (1) blood products and fluid resuscitation for hemostatic resuscitation, (2) utilization of prehospital blood products, (3) use of hemostatic adjuncts, (4) tourniquet use, (5) prehospital airway and blood pressure management, and (6) conventional coagulation tests or thromboelastography-guided resuscitation. A total of 21 recommendations are detailed in this article: 2 clinical recommendations, 14 expert consensus statements, and 5 good practice statements. The statement, the panel's voting outcome, and the rationale for each statement intend to give pediatric trauma providers the latest evidence and guidance to care for pediatric trauma patients experiencing hemorrhagic shock.With a broad multidisciplinary representation, the Pediatric Traumatic Hemorrhagic Shock Consensus Conference systematically evaluated the literature and developed clinical recommendations, expert consensus, and good practice statements concerning topics in traumatically injured pediatric patients with hemorrhagic shock.

Original languageEnglish (US)
Pages (from-to)S2-S10
JournalJournal of Trauma and Acute Care Surgery
Volume94
Issue number1
DOIs
StatePublished - Jan 1 2023

Keywords

  • Trauma
  • consensus
  • hemorrhage
  • pediatrics

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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