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J Pediatr Intensive Care 2015; 04(01): 004-009
DOI: 10.1055/s-0035-1554982
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Hemorrhagic Shock

Katherine W. Gonzalez
1   Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
,
Amita A. Desai
1   Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
,
Brian G. Dalton
1   Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
,
David Juang
1   Department of Pediatric Surgery, Children's Mercy Hospital, Kansas City, Missouri, United States
› Author Affiliations
Further Information

Publication History

05 October 2014

02 November 2014

Publication Date:
13 July 2015 (online)

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Abstract

Hemorrhagic shock has been studied extensively in the adult population, but evidence is lacking in the pediatric population. Unlike adults, pediatric patients tolerate hypovolemia with less hypotension until they have reached significant blood volume loss. It is imperative they receive prompt intravenous access, crystalloid resuscitation, followed by blood product transfusion. A hemoglobin goal of 7 g/dL has been translated to the pediatric population without evidence of poor outcomes. Massive transfusion protocols involving a 1:1:1 ratio of red blood cells:fresh frozen plasma:platelets has been recommended although further evidence is needed. With the transfusion of multiple blood products, consideration must be taken into account for the side effects, including electrolyte imbalance and lung injury.

Keywords

shock - massive transfusion - pediatrics - hemorrhage
 

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