New developments in massive transfusion in trauma
| Autor: | Kurt K Rhynhart, Sarah E. Greer, Rajan Gupta, Howard L Corwin |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
education.field_of_study
Resuscitation medicine.medical_specialty business.industry Population Factor VIIa Blood Coagulation Disorders medicine.disease Massive transfusion Recombinant Proteins Thrombelastography Anesthesiology and Pain Medicine Coagulopathy Medicine Humans Wounds and Injuries Blood Transfusion Preventable death business education Intensive care medicine |
| Zdroj: | Current opinion in anaesthesiology. 23(2) |
| ISSN: | 1473-6500 |
| Popis: | Trauma patients requiring massive transfusion represent a population at high risk for potentially preventable death. This review describes recent advances in the early recognition and treatment of the coagulopathy of trauma, as well as ongoing work to define optimal resuscitation strategies.Damage control resuscitation involves the rapid correction of hypothermia and acidosis, direct treatment of coagulopathy, and early transfusion in trauma patients. Recent evidence demonstrates improved mortality and lower overall blood product usage with higher ratios of plasma and platelets to red blood cells transfused. Adjuncts to damage control resuscitation such as factor VIIa may also be beneficial. Thrombelastography and advances in point-of-care testing may provide timely measurements to help guide massive transfusion in patients based on their individual needs.As optimal resuscitation strategies continue to evolve, recent efforts have focused on early and aggressive treatment of coagulopathy, with higher ratios of plasma and platelets to red blood cells transfused. Early evidence suggests that such strategies have a beneficial outcome in regards to trauma-related mortality. |
| Databáze: | OpenAIRE |
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