Pediatric Resuscitative Thoracotomy in Infants, Children, and Early Adolescents: A Scoping Review

Introduction: Recent publications sought to define the role of resuscitative thoracotomy (RT) in the pediatric population; however, few studies guide its use in young children and infants. This review characterizes the presentation and outcomes of patients <15 y old undergoing RT. Methods: A scoping review querying publications in PubMed, Embase, and Scopus prior to March 2024 was conducted using Covidence software. Eligible articles reported outcomes of patients aged <15 y old receiving RT for traumatic injury. The exclusion criteria included non-English, data in aggregate with patients >15 y old or lack of outcomes. Eligible articles underwent data extraction for mechanism of injury, hospital presentation, procedure details, and survival. Results: The search imported 1550 articles, 294 underwent full-text review, and 26 were included. Notably, 85 articles were excluded for failing to separate pediatric and adult outcomes. Reviewed literature reported on 459 pediatric patients, of which 81 survived (17.6%). Age reporting varied as follows: 10 articles reported the exact age, 5 reported age buckets, and 11 reported an age range only. Of the survivors with known ages, three were <1 y old, seven were 1-4 y old, ten were 5-9 y old, and 39 were 10-15 y old. Conclusions: The utility and indications for pediatric RT are understudied in the youngest children. Current literature is limited by inconsistent reporting and poor data granularity. Establishing universal reporting guidelines for pediatric RT will help build complete, uniform databases. A preliminary reporting checklist is proposed to improve data sharing in pediatric RT literature, serving as a first step toward developing evidence-based protocols for young children and infants undergoing RT.