Pediatric Massive Transfusion Protocol Dose Book: A Guide to Improve Balanced Ratios.

IF 0.9 4区医学 Q4 CRITICAL CARE MEDICINE

Journal of Trauma Nursing Pub Date : 2025-09-01 Epub Date: 2025-09-05 DOI:10.1097/JTN.0000000000000874

Tiffany L Taylor, Joshua Dugal, Steven P Laffey, Sandra P Spencer, Kelly B Thompson

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引用次数: 0

Abstract

Background: Pediatric massive transfusion protocol activation is rare, even in high-volume trauma centers. Maintaining competency in these low-frequency, high-risk events is challenging and often impedes balanced resuscitation.

Objective: This project aims to evaluate the effectiveness of a pediatric massive transfusion protocol dose book in improving packed red blood cell to plasma ratios during massive transfusion events.

Methods: This pre-post quality improvement study was conducted over 5 years (June 2019-March 2024) at an urban Midwestern U.S. pediatric Level I trauma center. Inclusion criteria were trauma patients under 18 years who received ≥40 mL/kg of blood products within the first 24 hours. The intervention was a novel weight-based dose book designed to guide balanced resuscitation. The primary outcome was adherence to a 1:1 packed red blood cell to plasma ratio.

Results: Among 29 massive transfusion activations, the average packed red blood cell-to-plasma ratio improved from 3.38:1 (preimplementation) (n = 14) to 1.37:1 (postimplementation) (n = 15).

Conclusion: Implementing a pediatric massive transfusion protocol dose book improved adherence to balanced blood product administration during massive transfusion events.

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儿科大量输血协议剂量书：指南，以提高平衡的比例。

背景：儿童大量输血方案的激活是罕见的，即使在高容量的创伤中心。在这些低频率、高风险的事件中保持能力是具有挑战性的，并且经常阻碍平衡的复苏。目的：本项目旨在评估儿科大量输血方案剂量手册在大量输血事件中改善包装红细胞与血浆比率的有效性。方法：这项前后质量改善研究在美国中西部城市儿科一级创伤中心进行了为期5年（2019年6月- 2024年3月）的研究。纳入标准是18岁以下的创伤患者，在前24小时内接受≥40 mL/kg的血液制品。干预是一种新的基于体重的剂量书，旨在指导平衡复苏。主要结局是红细胞与血浆的比例达到1:1。结果：在29次大规模输血激活中，平均包装红细胞与血浆比率从3.38:1（实施前）（n = 14）改善到1.37:1（实施后）（n = 15）。结论：实施儿科大规模输血方案剂量书提高了大规模输血事件中平衡血液制品管理的依从性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Trauma Nursing CRITICAL CARE MEDICINENURSING&-NURSING

CiteScore

1.20

自引率

10.00%

发文量

106

期刊介绍： Journal of Trauma Nursing (JTN) is the official journal of the Society of Trauma Nurses. The Society of Trauma Nurses believes that trauma is a disease impacting patients through the continuum of care. The mission of STN is to ensure optimal trauma care through education, collaboration, leadership and membership engagement. As the official publication of the Society of Trauma Nurses, the Journal of Trauma Nursing supports the STN’s strategic goals of effective communication, education and patient advocacy with original, peer-reviewed, research and evidence-based articles and information that reflect the highest standard of collaborative care for trauma patients. The Journal of Trauma Nursing, through a commitment to editorial excellence, implements STN’s vision to improve practice and patient outcomes and to become the premiere global nursing organization across the trauma continuum.