کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4155734 1273754 2014 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Reducing scheduled phlebotomy in stable pediatric patients with blunt liver or spleen injury
ترجمه فارسی عنوان
کاهش فلبوتومی برنامه ریزی شده در بیماران با پایدار اطفال مبتلا به کبد تلخ یا آسیب طحال
کلمات کلیدی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
چکیده انگلیسی

Background/PurposeAlthough consensus-based guidelines exist for managing pediatric liver/spleen injuries, optimal phlebotomy frequency is unknown. We hypothesize surgeons order more phlebotomy than necessary and propose a pathway with one blood draw, early ambulation and discharge, fewer ICU admissions, and physiology-driven interventions.MethodsRecords of 120 children with solid organ injury from two hospital registries (2008–2012) were analyzed. We compared resource utilization between our current management and management if the proposed pathway were in place. Paired t-test was used for statistical analysis.ResultsSixty-one patients were included (35 spleen, 22 liver, 4 combined). Average age was 11.6 (± 4.2) years, injury severity score 9 (± 5), and median injury grade 3. 51% of children were admitted to the ICU. Average phlebotomy per patient was 5 (± 2) and length-of-stay 4.3 (± 1.5) days. Three patients became unstable and required transfusion. No patients required operation or angioembolization. Our pathway would decrease ICU admissions by 65% (p < 0.001), blood draws by 70% (p < 0.001), and length-of-stay by 37% (p < 0.001), while identifying all patients requiring transfusion based on hemodynamic status.ConclusionOur data suggest that clinical parameters could identify patients requiring intervention and decrease resource utilization. This suggests that serial phlebotomy may be unnecessary, and the proposed pathway is worthy of prospective validation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 49, Issue 5, May 2014, Pages 759–762
نویسندگان
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