Document Detail


Transfusion in trauma: why and how should we change our current practice?
MedLine Citation:
PMID:  19390257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Major trauma is often associated with hemorrhage and transfusion of blood and blood products, which are all associated with adverse clinical outcome. The aim of this review is to emphasize why bleeding and coagulation has to be monitored closely in trauma patients and to discuss the rationale behind modern and future transfusion strategies. RECENT FINDINGS: Hemorrhage is a major cause of early death after trauma. Apart from the initial injuries, hemorrhage is significantly promoted by coagulopathy. Early identification of the underlying cause of hemorrhage with coagulation tests (routine and bedside) in conjunction with blood gas analysis allow early goal-directed treatment of coagulation disorders and anemia, thereby stopping bleeding and reducing transfusion requirements. These treatment options have to be adapted to the civilian and noncivilian sector. Transfusion of blood and its components is critical in the management of trauma hemorrhage, but is per se associated with adverse outcome. Decisions must weigh the potential benefits and harms. SUMMARY: Future transfusion strategies are based on early and continuous assessment of the bleeding and coagulation status of trauma patients. This allows specific and goal-directed treatment, thereby optimizing the patient's coagulation status early, minimizing the patient's exposure to blood products, reducing costs and improving the patient's outcome.
Authors:
Oliver M Theusinger; Donat R Spahn; Michael T Ganter
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  22     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-12     Citation Subset:  IM    
Affiliation:
Institute of Anesthesiology, University Hospital and University of Zurich, Zurich, Switzerland. oliver.theusinger@usz.ch
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Blood Coagulation Factors / therapeutic use*
Blood Transfusion / adverse effects,  methods*,  standards
Factor VIIa / therapeutic use
Factor XIII / therapeutic use
Fibrinogen / therapeutic use
Hemorrhage / diagnosis,  therapy*
Humans
Recombinant Proteins / therapeutic use
Wounds and Injuries / complications*,  therapy
Chemical
Reg. No./Substance:
0/Blood Coagulation Factors; 0/Recombinant Proteins; 0/recombinant FVIIa; 37224-63-8/prothrombin complex concentrates; 9001-32-5/Fibrinogen; 9013-56-3/Factor XIII; EC 3.4.21.21/Factor VIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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