Pediatric traumatic hemorrhagic shock consensus conference research priorities.

Authors

Robert T Russell
Melania M Bembea
Matthew A Borgman
Randall S Burd
Barbara A Gaines
Mubeen Jafri
Cassandra D Josephson
Christine M 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

Publication Date

1-1-2023

PMID

36203242

PMCID

PMC9805504

PubMedCentral® Posted Date

1-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Adolescent, Child, Humans, Shock, Hemorrhagic, Resuscitation, Shock, Traumatic, Research, Trauma, Pediatrics, Hemorrhage, Research, priorities

Abstract

BACKGROUND: Traumatic injury is the leading cause of death in children and adolescents. Hemorrhagic shock remains a common and preventable cause of death in the pediatric trauma patients. A paucity of high-quality evidence is available to guide specific aspects of hemorrhage control in this population. We sought to identify high-priority research topics for the care of pediatric trauma patients in hemorrhagic shock.

METHODS: A panel of 16 consensus multidisciplinary committee members from the Pediatric Traumatic Hemorrhagic Shock Consensus Conference developed research priorities for addressing knowledge gaps in the care of injured children and adolescents in hemorrhagic shock. These ideas were informed by a systematic review of topics in this area and a discussion of these areas in the consensus conference. Research priorities were synthesized along themes and prioritized by anonymous voting.

RESULTS: Eleven research priorities that warrant additional investigation were identified by the consensus committee. Areas of proposed study included well-designed clinical trials and evaluations, including increasing the speed and accuracy of identifying and treating hemorrhagic shock, defining the role of whole blood and tranexamic acid use, and assessment of the utility and appropriate use of viscoelastic techniques during early resuscitation. The committee recommended the need to standardize essential definitions, data elements, and data collection to facilitate research in this area.

CONCLUSION: Research gaps remain in many areas related to the care of hemorrhagic shock after pediatric injury. Addressing these gaps is needed to develop improved evidence-based recommendations for the care of pediatric trauma patients in hemorrhagic shock.