A decade of managing pediatric major traumatic vascular injuries: insights from a referral center

Ab. Rahman, Norhafiza and von Delft, Dirk and Numanoglu, Alp and Mohammad Aidid, Edre and Arnold, Marion (2024) A decade of managing pediatric major traumatic vascular injuries: insights from a referral center. Pediatric Surgery International, 40 (1). pp. 1-9. ISSN 0179-0358 E-ISSN 1437-9813

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Abstract

Purpose Incidence, management, and outcomes of pediatric vascular injuries secondary to non-iatrogenic trauma were reviewed over a decade in our institution. Methods a retrospective review of medical records (2013–2022) of major traumatic vascular injuries, focusing on injury profiles, treatment modalities, and clinical outcomes. Results thirty patients with 48 vessel injuries were included. Firearms were the leading mechanism, accounting for 43.3% (n = 13) of cases. We identified 29 arterial injuries and 19 venous injuries, with 30 (62.5%) of the overall injuries occurred in the lower extremities. Shock (17; 56.7%) and associated injuries (25; 83.3%) were common. Surgery was the most common management strategy. Autologous bypass graft was the most frequently performed procedure for arterial injuries (8; 42.1%), while ligation dominated in venous injuries (9; 64.3%). Blood transfusion requirements (24; 82.7%) and post-operative pre-scription of anticoagulant and antiplatelet agents (12; 41.4%) were similar for arterial and venous injuries (p > 0.05). Three patients demised, resulting in a 90% survival rate. Neither the mechanism of injury, anatomical location, and presence of shock on arrival nor the baseline hemoglobin level served as predictors of mortality. Conclusion intensive resuscitation with blood transfusion and prompt surgical intervention achieve favorable survival rates for pediatric traumatic vascular injuries. Optimal post-operative anticoagulant and antiplatelet regimens remain unclear.

Item Type:	Article (Journal)
Additional Information:	The research was not funded, however the open access was funded by the University of Cape Town.
Uncontrolled Keywords:	Pediatric trauma, Vascular injury, Vascular trauma, Firearms, Anticoagulant
Subjects:	R Medicine > R Medicine (General) R Medicine > RD Surgery R Medicine > RD Surgery > RD93 Emergency Surgery. Wounds and Injuries R Medicine > RJ Pediatrics > RJ101 Child Heatlh. Child health services. Preventive health services for children
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Surgery Kulliyyah of Medicine
Depositing User:	Dr Norhafiza Ab. Rahman
Date Deposited:	26 Nov 2024 07:32
Last Modified:	26 Nov 2024 07:32
URI:	http://irep.iium.edu.my/id/eprint/115904

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