Chapter 1 of 4 · Evidence & Research
Pediatric bleeding events
Life-threatening bleeding in children: prospective observational study
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Children with life-threatening bleeding are different than adults.
The Leonard et al. study was a prospective observational study of children presenting with life-threatening bleeding events across 24 centers between the US, Canada, and Italy.
Children were eligible for the bleeding study if they received more than 40 ccs per kilo of total blood products over six hours, or if they were transfused under massive transfusion protocol (MTP).
The Leonard et al. study compared patients presenting with traumatic bleeding, operative bleeding, and medical bleeding.
The Western Pediatric Surgery Research Consortium conducted a prospective cohort study on children undergoing colorectal surgery across 10 hospitals in the US.
The Tobias et al. study utilized an eight-part perioperative care bundle and split children into either a high or low compliance group.
Children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group.
Standardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery.
The Efting Scharincark et al. study is a retrospective study done in Netherlands between 1998 and 2018.
The Dutch stoma reversal study looked at patients under three years old that got a stoma reversal to see if they had contrast enema prior to it and if they were able to detect strictures.
The Dutch study gathered 244 patients, of whom 10% got strictures.
95% of patients with strictures had necrotizing enterocolitis.
Of all 244 patients in the Dutch study, only 68% had a contrast enema prior to the stoma reversal.
Contrast enema was able to detect 92% of the strictures in the Dutch stoma reversal study.
Contrast enema prior to stoma reversal is only useful if patients had necrotizing enterocolitis.