| Treatment alternatives in massive hemorrhage. | |
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MedLine Citation:
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PMID: 22321860 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Massive hemorrhage is the main cause of mortality and morbidity in trauma patients, and is one of the most important causes in any patient following major surgery. Conventional treatment consists of volume replacement, including the transfusion of blood products, so that tissue perfusion and oxygenation may be maintained. Associated hypothermia, acidosis and coagulopathy is a lethal triad. This review focuses on the latest therapeutic management of massive hemorrhage. The authors advocate the use of crystalloids as per protocol (controlled volumes) in order to achieve a systolic blood pressure of 85mmHg. The administration of the three blood products (red cells, plasma, and platelets) should be on a 1:1:1 basis. Where possible, this in turn should be guided by thromboelastography performed at point of care near the patient. Coagulopathy can occur early and late. With the exception of tranexamic acid, the cost-benefit relationships of the hemostatic agents, such as fibrinogen, prothrombin complex, and recombinant F VII, are subject to discussion. |
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Authors:
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E Fernández-Hinojosa; F Murillo-Cabezas; A Puppo-Moreno; S R Leal-Noval |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-7 |
Journal Detail:
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Title: Medicina intensiva / Sociedad Espanola de Medicina Intensiva y Unidades Coronarias Volume: - ISSN: 1578-6749 ISO Abbreviation: Med Intensiva Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9207689 Medline TA: Med Intensiva Country: - |
Other Details:
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Languages: ENG; SPA Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved. |
Affiliation:
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Servicio de Cuidados Críticos, Hospital Universitario Virgen del Rocío, Sevilla, España. |
Vernacular Title:
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Alternativas terapéuticas de la hemorragia masiva. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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