{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:06:58Z","timestamp":1779170818910,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Both whole blood (\n WB<\/jats:styled-content>\n ) and component therapy (\n CT<\/jats:styled-content>\n ) are used for hemostatic resuscitation in injured children. We hypothesize that early\n WB<\/jats:styled-content>\n transfusion compared to\n CT<\/jats:styled-content>\n alone is associated with decreased post\u2010traumatic organ dysfunction.\n <\/jats:p>\n <\/jats:sec>\n \n Study Design and Methods<\/jats:title>\n This single\u2010center observational study included children ages 0\u201317\u2009years between January 2021 and March 2024 with trauma mechanism and intensive care unit admission. The primary outcome was Pediatric Logistic Organ Dysfunction 2 (PELOD\u20102) score on post\u2010trauma days 1\u20137. Data were analyzed using linear regression adjusting for age, sex, race, year, injury mechanism, injury severity score (ISS), shock index pediatric age\u2010adjusted, and total 4\u2010h transfusion volume (mL\/kg).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 540 subjects met eligibility criteria; of the 52\/540 (10%) who received blood transfusion within 4\u2009h, 11\/52 (21%) received\n RBC<\/jats:styled-content>\n alone, 12\/52 (23%) received\n WB<\/jats:styled-content>\n alone, 9\/52 (17%) of subjects received\n RBC<\/jats:styled-content>\n plus other, and 20\/52 (38%) received\n WB<\/jats:styled-content>\n plus other. The cohort was 60% (326\/540) male, 83% (449\/540) blunt injury mechanism, median (interquartile range\n [IQR]<\/jats:styled-content>\n ) age 3\u2009years (0\u201311), and median (\n IQR<\/jats:styled-content>\n )\n ISS<\/jats:styled-content>\n of 11 (8\u201318). In adjusted analysis, transfusion of\n WB<\/jats:styled-content>\n \u2009+\u2009other was an independent predictor of lower\n PELOD<\/jats:styled-content>\n \u20102 score through post\u2010trauma day 7 in comparison to subjects receiving\n RBC<\/jats:styled-content>\n \u2009+\u2009other.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n In subjects who were transfused multiple blood products, receipt of any\n WB<\/jats:styled-content>\n versus\n CT<\/jats:styled-content>\n alone for hemostatic resuscitation after injury was associated with reduced organ dysfunction. Further investigation is needed in large cohorts to fully elucidate clinical benefit and improve mechanistic understanding.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/trf.70169","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:11:47Z","timestamp":1773382307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole blood resuscitation and post\u2010traumatic organ dysfunction in injured children"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1843-7995","authenticated-orcid":false,"given":"Erin V.","family":"Feeney","sequence":"first","affiliation":[{"name":"Department of Surgery University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madelyn A.","family":"Scarmack","sequence":"additional","affiliation":[{"name":"School of Medicine Lake Erie College of Medicine Erie, Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah M.","family":"Furman","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip C.","family":"Spinella","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne H.","family":"Kalinowski","sequence":"additional","affiliation":[{"name":"Department of Critical Care Children's Hospital of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Horvat","sequence":"additional","affiliation":[{"name":"Department of Critical Care Children's Hospital of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.","family":"Gaines","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Texas Southwestern Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Leeper","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.08.009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1702203"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000003802"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16979"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2019-000382"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000004075"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000003616"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003324"},{"key":"e_1_2_11_10_1","unstructured":"HolcombJB TilleyBC BaraniukS FoxEE WadeCE PodbielskiJM et al.Transfusion of plasma platelets and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.2015;313(5):471\u2013482."},{"issue":"1","key":"e_1_2_11_11_1","article-title":"The use of blood in pediatric trauma resuscitation","volume":"9","author":"Campwala I","year":"2024","journal-title":"Trauma Surg Acute Care Open"},{"issue":"3","key":"e_1_2_11_12_1","first-page":"S2","article-title":"The use of low\u2010titer group O whole blood is independently associated with improved survival compared to component therapy in adults with severe traumatic hemorrhage","volume":"60","author":"Shea SM","year":"2020","journal-title":"Transfusion"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.387"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000004378"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003306"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000004362"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000004443"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2023-001127"},{"issue":"1","key":"e_1_2_11_19_1","first-page":"S8","article-title":"Safety profile of low\u2010titer group O whole blood in pediatric patients with massive hemorrhage","volume":"61","author":"Morgan KM","year":"2021","journal-title":"Transfusion"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000002498"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17327"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31828a2bbd"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005251"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16509"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000006477"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.12.009"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003344"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.712276"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.14238\/pi60.5.2020.227-32"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0001105684.06157.93"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70169","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.70169","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.70169","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:21:34Z","timestamp":1779168094000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.70169"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,12]]},"references-count":29,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/trf.70169"],"URL":"https:\/\/doi.org\/10.1111\/trf.70169","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,12]]},"assertion":[{"value":"2025-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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