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Pediatric patients are more prone to trauma than adults. Trauma is one of the most common causes of death in children. Their small and fragile bodies, big organs relative to their bodies, are the major causes of injury in children. Their body surface area is relatively larger than adults, which makes them vulnerable to trauma. A higher percentage of the children admitted to emergency departments need the help of anesthesiologists in the management of airway, resuscitation, mechanical ventilation, maintenance of hemodynamic stability, transfusion, management of coagulopathy, hypothermia, pain, and monitorization. Serious abdominal trauma is seen in 5–10% of multiple traumas and 25% of blunt abdominal trauma in children. Despite improvements in emergency diagnostics and evaluation, controversy still exists regarding the optimal assessment and management of pediatric trauma patients with abdominal trauma. It can be difficult to accurately describe the major abdominal traumas and symptoms that occur in children. The most important factor in accurately detecting injuries that may occur due to abdominal trauma in this age group is high suspicion. Creating a targeted treatment strategy by understanding the mechanism of injury with a detailed and careful history and physical examination may be the basic step in saving life in these patients. This chapter is aimed to discuss the management of abdominal trauma in pediatric patients.

Introduction: Clear guidelines for red cell transfusion during cardiac surgery have not yet been established. The current focus on blood conservation during cardiac surgery has increased the urgency to determine the minimum safe hematocrit for these patients. The aim of this study was to determine whether monitoring of cerebral regional oxygen saturation (rSO2) via near-infrared spectrometry (NIRS) is effective for assessing the cerebral effects of severe dilutional anemia during elective coronary arterial bypass graft surgery (CABG).Methods: The prospective observational study involved patients who underwent cerebral rSO2 monitoring by NIRS during elective isolated first-time CABG: an anemic group (N=15) (minimum Hemoglobin (Hb) N=15) (Hb >8 g/dL during CPB). Mean arterial pressure (MAP), pump blood flow, blood lactate level, pCO2, pO2 at five time points and cross-clamp time, extracorporeal circulation time were recorded for each patient. Group results statistically were compared.Results: The anemic group had significantly lower mean preoperative Hb than the control group (10.3 mg/dL versus 14.2 mg/dL; P = .001). The lowest Hb levels were observed in the hypothermic period of CPB in the anemic group. None of the controls exhibited a >20% decrease in cerebral rSO2. Eleven (73.3%) of the anemic patients required an increase in pump blood flow to raise their cerebral rSO2.Conclusions: In this study, the changes in cerebral rSO2 in the patients with low Hb were within acceptable limits, and this was in concordance with the blood lactate levels and blood-gas analysis. It can be suggested that NIRS monitoring of cerebral rSO2 can assist in decision making related to blood transfusion and dilutional anemia during CPB.