Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2011 | 83 | 8 | 465-476

Article title

Recommendations for the Management of Trauma or Surgery-Related Massive Blood Loss

Content

Title variants

Languages of publication

EN

Abstracts

EN
Exsanguination is an underestimated cause of treatment failures in patients with severe trauma or undergoing surgery. In some patients the primary dysfunction of blood clot formation is a direct cause of a massive blood loss. Patients without previous coagulation disorders are at risk of coagulopathy following intraoperative or post-traumatic bleeding, where the local haemostasis does not warrant bleeding cessation.The aim of the study was to assess the therapeutic value of various components of a complex interdisciplinary approach, based on the opinion of the experts treating patients with massive bleeding.Material and methods. The study was conducted by anonymous questionnaire, using the analogue representation of the argument strength. The results were analyzed based on the techniques of descriptive statistics. The argument was considered a key parameter, when the median value of strength was located in the highest quartile.Results. It was found that the arguments of the highest strength for the risk of developing the posthaemorrhagic coagulation disorders are: loss of more than one third of blood volume, fluid therapy in an amount greater than 35 ml / kg, administration of more than 5 units of packed red blood cells, insufficient supply of fresh frozen plasma and platelets in proportion to packed red blood cells, severe acidosis and hypothermia. The most important tests for post-haemorrhage coagulopathy are: anatomically non-localized bleed, abnormal values of the standard coagulation parameters and fibrinogen level below 1 g / L. In the treatment of post-haemorrhagic coagulopathy the team of experts pointed out the benefits of antifibrinolytic drugs, concentrates of prothrombin complex and recombinant activated coagulation factor VII.Conclusions. Multidisciplinary therapeutic management of bleeding patients is associated with employment of appropriate treatment methods to achieve the best possible outcome. Factors influencing the development of coagulopathy, the methods of diagnosis and proposed techniques of treatment may facilitate therapeutic decisions in bleeding patients requiring massive transfusion of blood components.

Keywords

Publisher

Year

Volume

83

Issue

8

Pages

465-476

Physical description

Dates

published
1 - 8 - 2011
online
4 - 10 - 2011

Contributors

author
  • Department of General and Colorectal Surgery, Medical University in Łódź
author
author
  • Department of General and Colorectal Surgery, Medical University in Łódź
  • Chair and Department of Infectious Diseases and Hepatology, Pomeranian Medical University in Szczecin
author

References

  • Bolliger D, Szlam F, Levy JH et al.: Haemodilution-induced profibrinolytic state is mitigated by fresh-frozen plasma: implications for early haemostatic intervention in massive haemorrhage. Br J Anaesth 2010; 104: 318-25.[Crossref][PubMed][WoS]
  • Tsai TC, Rosing JH, Norton JA: Role of factor VII in correcting dilutional coagulopathy and reducing re-operations for bleeding following non-traumatic major gastrointestinal and abdominal surgery. J Gastrointest Surg 2010; 14: 1311-18.[PubMed][Crossref][WoS]
  • Rossaint R, Bouillon B, Cerny V et al.: Management of bleeding following major trauma: an updated European guideline. Crit Care 2010; 14: R52.[Crossref]
  • Johansson PI, Ostrowski SR, Secher NH: Management of major blood loss: an update. Acta Anaesthesiol Scand 2010; 54: 1039-49.[Crossref][WoS][PubMed]
  • Roberts I, Shakur H, Ker K et al.: Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev 2011; CD004896.[WoS]
  • Lier H, Bottiger BW, Hinkelbein J et al.: Coagulation management in multiple trauma: a systematic review. Intensive Care Med 2011; 37: 572-82.[WoS]
  • Inaba K, Teixeira PG, Rhee P et al.: Mortality impact of hypothermia after cavitary explorations in trauma. World J Surg 2009; 33: 864-69.[Crossref][WoS]
  • Johansson PI, Ostrowski SR: Acute coagulopathy of trauma: balancing progressive catecholamine induced endothelial activation and damage by fluid phase anticoagulation. Med Hypotheses 2010; 75: 564-67.[WoS][PubMed][Crossref]
  • Van der Linde P, Ickx BE: The effects of colloid solutions on hemostasis. Can J Anaesth 2006; 53(6 Suppl): S30-39.
  • Fujita Y, Doi K, Harada D et al.: Modulation of physiological hemostasis by irrigation solution: comparison of various irrigation solutions using a mouse brain surface bleeding model. J Neurosurg 2010; 112: 824-28.[Crossref][WoS]
  • Spahn DR, Ganter MT: Towards early individual goal-directed coagulation management in trauma patients. Br J Anaesth 2010; 105: 103-05.[Crossref][WoS]
  • Bradley C: Crystalloid, colloid or small volume resuscitation? Intensive Crit Care Nurs 2001; 17: 304-06.[PubMed][Crossref]
  • Gryth D, Rocksen D, Drobin D et al.: Effects of fluid resuscitation with hypertonic saline dextrane or Ringer's acetate after nonhemorrhagic shock caused by pulmonary contusion. J Trauma 2010; 69: 741-48.[WoS][Crossref]
  • Kreimeier U, Prueckner S: Small-volume resuscitation from hemorrhagic shock by hypertonic saline dextran - conceptional basis and historical background. Eur Surg Res 2002; 34: 138-44.[PubMed][Crossref]
  • Holcomb JB, Wade CE, Michalek JE et al.: Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg 2008; 248: 447-58.[WoS]
  • Dente CJ, Shaz BH, Nicholas JM et al.: Improvements in early mortality and coagulopathy are sustained better in patients with blunt trauma after institution of a massive transfusion protocol in a civilian level I trauma center. J Trauma 2009; 66: 1616-24.[Crossref][WoS]
  • Horst HM, Dlugos S, Fath JJ et al.: Coagulopathy and intraoperative blood salvage (IBS). J Trauma 1992; 32: 646-52.[Crossref][PubMed]
  • Kashuk JL, Moore EE, Johnson JL et al.: Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer? J Trauma 2008; 65: 261-70.[WoS][Crossref][PubMed]
  • Martini WZ, Holcomb JB: Acidosis and coagulopathy: the differential effects on fibrinogen synthesis and breakdown in pigs. Ann Surg 2007; 246: 831-35.[Crossref][WoS][PubMed]
  • Zhang WB, Wang WY, Wang GF et al.: Risk factors of mortality in non-trauma exsanguinating patients that require damage control laparotomy. ANZ J Surg 2010; 80: 258-64.[Crossref]
  • Davenport RA, Brohi K: Coagulopathy in trauma patients: importance of thrombocyte function? Curr Opin Anaesthesiol 2009; 22: 261-66.[PubMed][WoS][Crossref]
  • Hess JR, Brohi K, Dutton RP et al.: The coagulopathy of trauma: a review of mechanisms. J Trauma 2008; 65: 748-54.[Crossref]
  • Curry N, Stanworth S, Hopewell S et al.: Trauma-Induced Coagulopathy-A Review of the Systematic Reviews: Is There Sufficient Evidence to Guide Clinical Transfusion Practice? Transfus Med Rev 2011; doi: 10.1016/j.tmrv.2011.01.001.[WoS][Crossref]
  • Brenni M, Worn M, Bruesch M et al.: Successful rotational thromboelastometry-guided treatment of traumatic haemorrhage, hyperfibrinolysis and coagulopathy. Acta Anaesthesiol Scand 2010; 54: 11117.[WoS]
  • Leemann H, Lustenberger T, Talving P et al.: The role of rotation thromboelastometry in early prediction of massive transfusion. J Trauma 2010; 69: 1403-08.[WoS][Crossref]
  • Keyl C, Kmitta E, Kueri S et al.: Effects of aspirin and desmopressin on platelet reactivity in patients undergoing cardiac surgery with extracorporeal circulation. Thromb Haemost 2011; 105: 113-21.[WoS]
  • Shakur H, Roberts I, Bautista R et al.: Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet 2010; 376: 23-32.[WoS]
  • Geeraedts LM, Jr., Kaasjager HA, van Vugt AB et al.: Exsanguination in trauma: A review of diagnostics and treatment options. Injury 2009; 40: 11-20.[Crossref][WoS]
  • Topf HG, Weiss D, Lischetzki G et al.: Evaluation of a modified thromboelastography assay for the screening of von Willebrand disease. Thromb Haemost 2011; 105: doi:10.1160/TH10-12-0782.[WoS][Crossref]
  • Scharf RE, Rahman MM, Seidel H: The impact and management of acquired platelet dysfunction. Hamostaseologie 2011; 31: 28-40.[PubMed][WoS][Crossref]
  • Weiss JP. Rational use of desmopressin in adults. J Urol 2011; 185: 12-13.[WoS]
  • Coggin MH, Ahl R, Roland A et al.: Protamine sulfate stimulates degradation of factor Xa and the factor Xa-antithrombin complex. Blood Coagul Fibrinolysis 2011; 22: 247-53.[WoS][Crossref]
  • De BD, Biston P, Devriendt J et al.: Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 2010; 362: 779-89.[WoS]
  • Vang ML, Hvas AM, Ravn HB: Urgent reversal of vitamin K antagonist therapy. Acta A naesthesiol Scand 2011; doi:10.1111/j.1399-6576.2011.02414.x.[WoS][Crossref]
  • Demeyere R, Gillardin S, Arnout J et al.: Comparison of fresh frozen plasma and prothrombin complex concentrate for the reversal of oral anticoagulants in patients undergoing cardiopulmonary bypass surgery: a randomized study. Vox Sang 2010; 99: 251-60.[Crossref][WoS]
  • Levi M, Peters M, Buller HR: Efficacy and safety of recombinant factor VIIa for treatment of severe bleeding: a systematic review. Crit Care Med 2005; 33: 883-90.[Crossref][PubMed]
  • Holcomb JB: Use of recombinant activated factor VII to treat the acquired coagulopathy of trauma. J Trauma 2005; 58: 1298-1303.[PubMed][Crossref]
  • Grounds RM, Seebach C, Knothe C et al.: Use of recombinant activated factor VII (Novoseven) in trauma and surgery: analysis of outcomes reported to an international registry. J Intensive Care Med 2006; 21: 27-39.[Crossref]
  • Logan AC, Goodnough LT: Recombinant factor VIIa: an assessment of evidence regarding its efficacy and safety in the off-label setting. Hematology Am Soc Hematol Educ Program 2010; 2010: 153-59.[WoS]

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_v10035-011-0073-x
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.