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27.04.2019 | Original Article

Aggressive crystalloid adversely affects outcomes in a pediatric trauma population

Zeitschrift:
European Journal of Trauma and Emergency Surgery
Autoren:
Hai Zhu, Bailin Chen, Chunbao Guo

Abstract

Introduction

Crystalloid resuscitation for trauma patients is deleterious, and minimizing crystalloid use is advocated. The purpose of this study was to evaluate the adverse effects of high-volume resuscitation in pediatric blunt trauma patients.

Methods

This study included a retrospective review of 291 patients with blunt trauma from January 2007 to Apr 2018 at the Children’s Hospital, Chongqing Medical University. Patients were dichotomized into low and high groups depending on the average dose of crystalloid fluid administration with a cut-off point during the first 24 or 48 h. Propensity score matching was used based on measurable baseline factors to minimize confounding. The associations between crystalloid administration and clinical outcomes were determined according to the corresponding methods.

Results

Patients who received larger doses of crystalloids were more likely than the low-volume group to be associated with severe anemia (p = 0.033, p = 0.042, respectively), RBC transfusion (p = 0.016, p = 0.009, respectively) and longer hospital length of stay (p = 0.008, p = 0.002, respectively). In terms of plasma transfusion and oral solid diet, there were marginally significant differences noted in the dichotomized groups at 24 h (p = 0.074), with significant differences at 48 h (p =  0.013).

Conclusion

Significant unfavorable outcomes were noted following excessive crystalloid resuscitation within the first 48 h among pediatric patients with blunt trauma. Our findings support the notion that excessive fluid resuscitation should be avoided.

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