Организационные аспекты терапии острой массивной кровопотери при хирургической коррекции онкологических заболеваний у детей

The organization of acute massive blood loss therapy in pediatric surgical requires an interdisciplinary approach in each medical center, depending on their profile. In our center, a protocol of acute massive blood loss therapy in pediatric surgical oncology has been developed and implemented. Systematic training of personnel and the development of team skills in the simulation class of the center became the basis for its implementation. In addition, the earlier initiation of therapy (with blood loss of more than 1 ml/kg/min) and actions aimed at reducing the time of critical hypotension became important conditions of the protocol. The acquired coagulopathy therapy and the prevention of massive transfusion syndrome are carried out only after the normalization of systemic hemodynamics. We present our experience of using this protocol in a 3-year-old child with acute massive blood loss more than 400% of the circulating blood volume during surgical removal of сhoriocarcinoma. The presented clinical case demonstrates not only the dramatic nature of the course of the disease, but also the good results of the organization and coordination of the joint work of all the center’s specialists. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. Parents gave their consent to use information about the child, including fotos, in the article.