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Adverse events after low titer group O whole blood versus component product transfusion in pediatric trauma patients: A propensity‐matched cohort study
Author(s) -
Leeper Christine M.,
Yazer Mark H.,
Morgan Katrina M.,
Triulzi Darrell J.,
Gaines Barbara A.
Publication year - 2021
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16509
Subject(s) - medicine , injury severity score , sepsis , propensity score matching , acute kidney injury , adverse effect , blood product , packed red blood cells , blood transfusion , trauma center , bacteremia , whole blood , anesthesia , retrospective cohort study , emergency medicine , surgery , poison control , injury prevention , microbiology and biotechnology , biology , antibiotics
Background Low titer group O whole blood (LTOWB) is used as the initial resuscitative fluid in an increasing number of pediatric trauma and massive bleeding transfusion protocols. There is little data on adverse events following its transfusion in pediatric trauma patients. Study Design and Methods Blood bank records were queried for pediatric recipients of at least one unit of red blood cells (RBCs) (component group) or LTOWB (LTOWB group) within 24 h of admission between May 2013 and August 2020. Subjects with early death (<72 h) were excluded. Propensity‐score matching of LTOWB and component groups was performed. Adverse events were recorded, including transfusion reaction, thromboembolism, acute kidney injury, sepsis, and organ failure based on PELOD‐2 score, along with hospital and ICU length of stay (LOS) and ventilator days. Results Thirty‐six LTOWB recipients were matched to 36 conventional component recipients. Subjects were 52% male, with blunt injury mechanism (82%), median (IQR) injury severity score = 27 (21–35), and 26% in‐hospital mortality. The groups were well matched in terms of demographics and injury characteristics. There were no clinically or statistically significant differences in adverse outcomes including reported transfusion reaction, organ failure, acute kidney injury, sepsis/bacteremia, and venous thromboembolism. Hospital LOS, ventilator days, mortality, and functional disability at discharge were also not significantly different. The LTOWB group had significantly shorter ICU LOS compared to the component group. Conclusion LTOWB transfusion did not increase the risk of adverse events in children. However, larger studies are required to confirm these results.