| Transfusion in trauma: why and how should we change our current practice? | |
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MedLine Citation:
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PMID: 19390257 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Oliver M Theusinger; Donat R Spahn; Michael T Ganter |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in anaesthesiology Volume: 22 ISSN: 1473-6500 ISO Abbreviation: Curr Opin Anaesthesiol Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-24 Completed Date: 2009-11-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8813436 Medline TA: Curr Opin Anaesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 305-12 Citation Subset: IM |
Affiliation:
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Institute of Anesthesiology, University Hospital and University of Zurich, Zurich, Switzerland. oliver.theusinger@usz.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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