01 April 2016 : Case report
Massive Transfusion of 5 U Packed Redblood Cells, 3 U Fresh Frozen Plasma, and 160 cc of Platelets in a 14-Month-Old Patient
Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Clinical situation which can not be reproduced for ethical reasons
Tanaya SparkleEF, Staci CameronEFDOI: 10.12659/AJCR.896820
Am J Case Rep 2016; 17:211-213
Abstract
BACKGROUND: We present a case in which extremely rapid massive transfusion was successfully used to combat severe acute bleeding during a parietooccipital tumor resection in a 14-month-old patient.
CASE REPORT: An 8-kg patient was found to have a 4×5×5-cm parietooccipital tumor on computed tomography scan, for which resection was urgently planned. Sudden acute bleeding was encountered, which was communicated to the anesthesia team. Transfusion was initiated and a total of 5 units of packed red blood cells, 3 units of fresh frozen plasma, 160 ml of platelets, 200 ml of albumin, and 500 ml of 0.9% normal saline were transfused during a 4-h period. We administered 4 g of mannitol and 0.8 mg of furosemide to deal with anticipated fluid overload. The patient was sent to the intensive care unit and extubated the next day. No clinically significant hemostatic or fluid overload complications were noted after the treatment.
CONCLUSIONS: Massive transfusion (MT) was found to be safe and effective in this case. Most of what we know about pediatric MT is an extrapolation of data from adult studies. Although practical, it might not be ideal due to the differences in the physiology and incomplete development of hemostatic mechanisms in children, especially those younger than 12 months. Studies evaluating the use of pediatric MT protocols have not shown a significant advantage over transfusion per clinician discretion.
Keywords: Erythrocyte Transfusion, Brain Neoplasms - surgery, Hemorrhage - therapy, Infant, Intraoperative Complications, Occipital Lobe - surgery, Plasma, Platelet Transfusion
In Press
14 Mar 2024 : Case report
Bilateral Low-Flow Type-D Dural Carotid-Cavernous Fistula: Diagnosis and Treatment with 3D Time-of-Flight M...Am J Case Rep In Press; DOI: 10.12659/AJCR.942833
31 Jan 2024 : Case report
Gaucher Disease Coexisting with Cytomegalovirus Infection: A Rare Presentation in an InfantAm J Case Rep In Press; DOI: 10.12659/AJCR.943398
31 Jan 2024 : Case report
Unconjugated Hyperbilirubinemia in Acetaminophen-Related Acute Liver FailureAm J Case Rep In Press; DOI: 10.12659/AJCR.942703
31 Jan 2024 : Case report
A 58-Year-Old Woman with Acute Torsion of the Small Bowel Due to Diffuse Intestinal LipomatosisAm J Case Rep In Press; DOI: 10.12659/AJCR.942527
Most Viewed Current Articles
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
05 Mar 2022 : Case report
Acute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...DOI :10.12659/AJCR.935336
Am J Case Rep 2022; 23:e935336
02 Apr 2022 : Case report
Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient. A Case Report and Review of Li...DOI :10.12659/AJCR.935743
Am J Case Rep 2022; 23:e935743