Hemorrhagic Shock with Dr. Matthew Borgman

Nov 18, 2024

Dr. Matthew Borgman, a Professor of Pediatrics specializing in Critical Care, shares his vast expertise in managing pediatric hemorrhagic shock. He delves into the complexities of recognizing and treating this condition, emphasizing careful fluid resuscitation and the strategic use of blood products. The discussion highlights the advantages of low titer group O whole blood and advanced coagulation testing methods like TEG and ROTEM. Borgman also addresses the challenges of implementing these practices in various healthcare settings, paving the way for improved trauma care.

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Episode notes

Intro

00:00 • 3min

Managing Pediatric Hemorrhagic Shock

03:25 • 6min

Optimal Management of Blood Products in Trauma Care

09:19 • 11min

Assessing Hemorrhagic Shock: Clinical Indicators and Biomarkers

20:01 • 2min

Optimizing Pediatric Trauma Care with Whole Blood

21:59 • 15min

Advancing Trauma Care with TEG and ROTEM

37:25 • 5min

Managing Coagulopathy in Trauma Care

42:33 • 5min

Concluding Insights on Hemorrhagic Shock Management

47:08 • 2min

Matthew A. Borgman, M.D. is a Professor of Pediatrics in the Division of Pediatric Critical Care at the University of Texas Southwestern. Dr. Borgman graduated from Uniformed Services University (USU), he completed Pediatric Residency at Brooke Army Medical Center in 2007, followed by a fellowship in Critical Care at Boston Children’s Hospital. He is a prolific author in pediatric trauma management which has helped redefine the care of injured children. He is also the former national chair of the Pediatric Trauma Society Research Committee and has co-authored the 2022 Pediatric Traumatic Hemorrhagic Shock Consensus Conference Recommendations.

Learning Objectives:

By the end of this podcast, listeners should be able to:

Define pediatric hemorrhagic shock and massive transfusion.
Develop a guideline-based clinical approach to managing a child with hemorrhagic shock.
Explore an expert’s approach to managing a child with hemorrhagic shock where the evidence might not be clear.

References:

Russell et al. Pediatric traumatic hemorrhagic shock consensus conference recommendations. J Trauma Acute Care Surg. 2023 Jan 1;94(1S Suppl 1):S2-S10.
Spinella et al. Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding. Pediatr Crit Care Med. 2022 Apr 1;23(4):235-244.
Gaines et al. Low Titer Group O Whole Blood In Injured Children Requiring Massive Transfusion. Ann Surg. 2023 Apr 1;277(4):e919-e924.
Roberts et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013 Mar;17(10):1-79.
Dewan et al. CRASH-3 - tranexamic acid for the treatment of significant traumatic brain injury: study protocol for an international randomized, double-blind, placebo-controlled trial. Trials. 2012 Jun 21;13:87.
Spinella et al. Survey of transfusion policies at US and Canadian children's hospitals in 2008 and 2009. Transfusion. 2010 Nov;50(11):2328-35.
MATIC-2: https://classic.clinicaltrials.gov/ct2/show/NCT06070350

Citation: Borgman M, Shanklin A, Hodges Z. Hemorrhagic Shock. PedsCrit. Online Podcast. 11/2024.

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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.