Massive blood loss in pediatric practice

Abstract

Background. Massive blood loss is one of the main causes of deaths and complications both in patients requiring extensive surgical interventions and those with severe trauma.Aim. To analyse available publications devoted to the definition, pathogenesis, diagnosis and intensive care of acute massive blood loss in children.Materials and methods. The conducted analysis involved 102 publications by Russian and foreign authors from the PubMed database devoted to the problem of massive blood loss in children.General findings. The paper presents modern definitions of massive blood loss in children. Special attention is paid to the pathogenesis, diagnosis and treatment of massive blood loss in severe trauma cases. The principles of correcting the deficiency of circulating blood volume, the use of inotropic and vasopressor drugs, as well as the elimination of severe anemia and hemostasis disorders, are considered. Publications devoted to the search for an optimal ratio of globular and plasma volumes during the transfusion of blood components are reviewed. It is shown that the reviewed publications report conflicting opinions regarding the use of antifibrinolytic medications. At the same time, the high efficiency of tranexamic acid and its positive effect on the functional outcome in patients with severe trauma is demonstrated. In order to optimize approaches to the management of massive blood loss in children, additional multicenter studies are required. These studies should consider the effect of the underlying disease that caused massive blood loss, as well as the treatment and diagnostic capacity of hospitals.