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To define massive transfusion for the pediatric population and thus aid future development of pediatric-specific trauma resuscitation protocols, investigators retrospectively reviewed outcomes of children who presented to U.S. combat hospitals in Iraq and Afghanistan with traumatic injuries and required any blood products (whole blood, packed red blood cells, fresh frozen plasma, platelets, or cryoprecipitate) within 24 hours. Children with severe isolated or predominant head injuries were excluded. The study included 1113 children (median age, 10 years) who presented from 2001 to 2013.
Using sensitivity and specificity plots for 24-hour and in-hospital mortality, the authors identified 40 mL/kg of blood products as the optimal cut-off for d…