Management of bleeding following major trauma: an updated European guideline
Rolf Rossaint,Bertil Bouillon,Vladimir Cerny,Timothy J Coats,Jacques Duranteau,Enrique Fernández-Mondéjar,Beverley J. Hunt,Radko Komadina,Giuseppe Nardi,Edmund Neugebauer,Yves Ozier,Louis Riddez,Arthur Schultz,Philip F. Stahel,Jean Louis Vincent,Donat R. Spahn +15 more
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This document presents an updated version of the guideline for the management of bleeding following severe injury, which provides an evidence-based multidisciplinary approach to themanagement of critically injured bleeding trauma patients.Abstract:
Introduction: Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient, which when implemented may improve patient outcomes. Methods: The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document presents an updated version of the guideline published by the group in 2007. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. Results: Key changes encompassed in this version of the guideline include new recommendations on coagulation support and monitoring and the appropriate use of local haemostatic measures, tourniquets, calcium and desmopressin in the bleeding trauma patient. The remaining recommendations have been reevaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. Conclusions: This guideline provides an evidence-based multidisciplinary approach to the management of critically injured bleeding trauma patients.read more
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The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition
Rolf Rossaint,Bertil Bouillon,Vladimir Cerny,Timothy J Coats,Jacques Duranteau,Enrique Fernández-Mondéjar,Daniela Filipescu,Beverley J. Hunt,Radko Komadina,Giuseppe Nardi,Edmund Neugebauer,Yves Ozier,Louis Riddez,Arthur Schultz,Jean Louis Vincent,Donat R. Spahn +15 more
TL;DR: The guideline now recommends that patients be transferred directly to an appropriate trauma treatment centre and encourages use of a restricted volume replacement strategy during initial resuscitation, and may also serve as a basis for local implementation.
Journal ArticleDOI
Management of severe perioperative bleeding Guidelines from the European Society of Anaesthesiology
Sibylle A. Kozek-Langenecker,Arash Afshari,Pierre Albaladejo,Cesar Aldecoa Alvarez Santullano,Edoardo De Robertis,Daniela Filipescu,Dietmar Fries,Thorsten Haas,Georgina Imberger,Matthias Jacob,Marcus D. Lancé,Juan V. Llau,Susan Mallett,Jens Meier,Niels Rahe-Meyer,Charles Marc Samama,Andrew Smith,Cristina Solomon,Philippe Van der Linden,Anne Wikkelsø,Patrick Wouters,Piet Wyffels +21 more
TL;DR: These guidelines are intended to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible.
Journal ArticleDOI
Acute traumatic coagulopathy.
TL;DR: Conventional concepts of traumatic coagulopathy as a late occurring condition in response to iatrogenic haemodilution are redundant and ATC is an endogenous impairment of haemostasis that begins at the moment of injury.
Journal ArticleDOI
Management of bleeding and coagulopathy following major trauma: an updated European guideline
Donat R. Spahn,Bertil Bouillon,Vladimir Cerny,Timothy J Coats,Jacques Duranteau,Enrique Fernández-Mondéjar,Daniela Filipescu,Beverley J. Hunt,Radko Komadina,Giuseppe Nardi,Edmund Neugebauer,Yves Ozier,Louis Riddez,Arthur Schultz,Jean Louis Vincent,Rolf Rossaint +15 more
TL;DR: Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants.
This Provisional PDF corresponds to the article as it appeared upon acceptance. Copyedited and fully formatted PDF and full text (HTML) versions will be made available soon. Management of bleeding and coagulopathy following major trauma: an updated European guideline
Donat R. Spahn,Bertil Bouillon,Timothy J Coats,Jacques Duranteau,Enrique Fernández-Mondéjar,Daniela Filipescu,Beverley J. Hunt,Giuseppe Nardi,Edmund Neugebauer,Louis Riddez,Arthur Schultz,Jean Louis Vincent +11 more
TL;DR: In this article, the authors presented an updated version of the guideline published by the Task Force for Advanced Bleeding Care in Trauma and updated in 2010, which included new recommendations on the appropriate use of vasopressors and inotropic agents.
References
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Journal ArticleDOI
Blood transfusion is an independent predictor of mortality after blunt trauma.
TL;DR: There must be a continuous attempt to limit blood transfusion when feasible and physiologically appropriate in this blunt trauma population, and transfusing ≥2U blood was strongly associated with mortality in these blunt trauma patients.
Journal ArticleDOI
Tranexamic acid and aprotinin in primary cardiac operations: an analysis of 220 cardiac surgical patients treated with tranexamic acid or aprotinin.
Wulf Dietrich,Michael Spannagl,Johannes Boehm,Katharina Hauner,Siegmund Braun,Tibor Schuster,Raimund Busley +6 more
TL;DR: Considering the rate of transfusion of red blood cells, tranexamic acid was slightly inferior in patients undergoing CABG, but there was no difference in patients receiving AVR, although 24-h blood loss was reduced in aprotinin-treated CABg patients.
Journal ArticleDOI
Damage control surgery.
B. A. Hoey,C. W. Schwab +1 more
TL;DR: The concept of abdominal packing for uncontrolled hemorrhage, one of the initial damage control maneuvers, is not a new one as discussed by the authors, it has been described most often in patients with massive liver.
Journal ArticleDOI
Death in the operating room: An analysis of a multi-center experience
David B. Hoyt,Eileen M. Bulger,M. Margaret Knudson,John A. Morris,R Ierardi,Harvey J. Sugerman +5 more
TL;DR: It is concluded that delayed transfer to the OR remains a problem with significant BP deterioration during delay, particularly following interfacility transfer, and staged injury isolation and repair to allow better resuscitation and warming may lead to improved results.