TITLE

Management of bleeding and coagulopathy following major trauma: an updated European guideline

AUTHOR(S)
Spahn, Donat R.; Bouillon, Bertil; Cerny, Vladimir; Coats, Timothy J.; Duranteau, Jacques; Fernýndez-Mondéjar, Enrique; Filipescu, Daniela; Hunt, Beverley J.; Komadina, Radko; Nardi, Giuseppe; Neugebauer, Edmund; Ozier, Yves; Riddez, Louis; Schultz, Arthur; Vincent, Jean-Louis; Rossaint, Rolf
PUB. DATE
June 2013
SOURCE
Critical Care;2013, Vol. 17 Issue 2, p1
SOURCE TYPE
Periodical
DOC. TYPE
Article
ABSTRACT
Introduction: Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved. 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 represents an updated version of the guideline published by the group in 2007 and updated in 2010. 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 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. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated 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: A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond.
ACCESSION #
88013881

 

Related Articles

  • Code RED. Cohen, David // New Scientist;10/22/2011, Vol. 212 Issue 2835, p48 

    The article discusses an approach to the treatment of traumatic hemorrhage that focuses on coagulation as the most important factor in the survival of the patient. A study by surgeon Karim Brohi into patients with acute traumatic coagulopathy (ATC) found that an increase in the production of...

  • A mathematical model for fresh frozen plasma transfusion strategies during major trauma resuscitation with ongoing hemorrhage. Ho, Anthony M. H.; Dion, Peter W.; Cheng, Claudia A. Y.; Karmakar, Manoj K.; Cheng, Gregory; Zhiyong Peng; Yu Wai Ng // Canadian Journal of Surgery;Dec2005, Vol. 48 Issue 6, p470 

    Background Randomized controlled trials of how best to administer fresh frozen plasma (FFP) in the presence of ongoing severe traumatic hemorrhage are difficult to execute and have not been published. Meanwhile, coagulopathy remains a common occurrence during major trauma resuscitation and...

  • Towards early individual goal-directed coagulation management in trauma patients. Spahn, D. R.; Ganter, M. T. // BJA: The British Journal of Anaesthesia;Aug2010, Vol. 105 Issue 2, p103 

    The author reflects on blood coagulation management in trauma patients. He explains the frequency of acute coagulopathy in trauma patients, which often times have worse clinical results. Citing previous studies and results, he stresses a goal to establish algorithms allowing early individual...

  • Synovial Sarcoma Mimicking Haemophilic Pseudotumour. Mann, Haroon A.; Hilton, Andrew; Goddard, Nicholas J.; Smith, Michael A.; Holloway, Brian; Lee, Christine A. // Sarcoma;2006, Vol. 2006, p1 

    This is a case of a 36-year-old gentleman with haemophilia A who was presented with an acute atraumatic soft tissue swelling in the right thigh. Open biopsy was performed with the resultant diagnosis of a synovial cell sarcoma. Although the clinical findings were nonspecific they could easily...

  • Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease. Lockhart, P. B.; Gibson, J.; Pond, S. H.; Leitch, J. // British Dental Journal;10/25/2003, Vol. 195 Issue 8, p439 

    Current teaching suggests that many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to an acquired coagulopathy from systemic disease and/or from medications. However, treatment standards for these patients often are the result of long-standing...

  • Gene Therapy for Hemophilia. Miller, Daniel G.; Stamatoyannopoulos, George // New England Journal of Medicine;06/07/2001, Vol. 344 Issue 23, p1782 

    Editorial. Discusses the treatment of hemophilia. Details of various approaches to gene therapy for hemophilia; The transkaryotic approach used by Roth et al, as reported in the June 7, 2001 issue of 'The New England Journal of Medicine'; Key differences between the study and previous...

  • Recombinant Activated Factor VII: An Addition to Replacement Therapy in Trauma Patients with Uncontrolled Massive Bleeding. Tipsunthonsak, Nakhon; Chadbunchachai, Wittaya; Ruangwannasak, Somchai; Chuansumrit, Ampaiwan // Thai Journal of Surgery;Jan-Mar2008, Vol. 29 Issue 1, p32 

    Introduction: Trauma patients tend to have multiple sites of bleeding, sometimes in surgically inaccessible areas of the pelvis and retroperitoneum or in an organ that is difficult to control or repair such as the liver. Massive transfusion will lead to various complications of dilutional...

  • ACQUIRED FACTOR V INHIBITORS IN A POLYTRAUMATIZED PATIENT. Tukić, Ljiljana; Stamatović, Dragana; Tarabar, Olivera; Elez, Marija; Zorić, Miodrag; Mandić-Radić, Slavka // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Jul/Aug2005, Vol. 62 Issue 7/8, p587 

    Background. Factor V (FV) inhibitors are a rare disorder reported for the first time about fifty years ago, mostly with the unknown cause. The appearance of FV inhibitors is usually preceded by surgery, infections, administration of antibiotics or transfusions. Clinical manifestations of the...

  • Behandlung von polytraumatisierten Patienten. Grottke, O.; Spahn, D.R.; Rossaint, R. // Anaesthesist;Jun2011, Vol. 60 Issue 6, p546 

    Despite improved strategies in the treatment of polytraumatized patients the mortality rate of severely injured patients remains high. Thus, worldwide 5 million patients die due to trauma or trauma-related complications each year. As the majority of early trauma-related deaths are attributed to...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics