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Management of bleeding and coagulopathy following major trauma: an updated European guideline
- Source :
- Critical care 17(2), R76 (2013). doi:10.1186/cc12685, Critical care, 17 (2
- Publication Year :
- 2013
- Publisher :
- Springer Science and Business Media LLC, 2013.
-
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. © 2013 Spahn et al. licensee BioMed Central Ltd.<br />SCOPUS: ar.j<br />info:eu-repo/semantics/published
- Subjects :
- Soins intensifs réanimation
Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings]
Trastornos de la coagulación sanguínea
Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Blood Coagulation Disorders [Medical Subject Headings]
Choque Hemorrágico
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Heridas y Traumatismos
Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]
0302 clinical medicine
Hemorragia
Nominal group technique
Medicine
Diseases::Wounds and Injuries [Medical Subject Headings]
Disease management (health)
Antifibrinolíticos
Resucitación
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatment [Medical Subject Headings]
education.field_of_study
Major trauma
Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Coagulants::Hemostatics::Antifibrinolytic Agents [Medical Subject Headings]
Tratamiento de Urgencia
Humanos
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Therapeutic Occlusion::Embolization, Therapeutic [Medical Subject Headings]
3. Good health
Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Blood Substitutes [Medical Subject Headings]
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Hemostatic Techniques [Medical Subject Headings]
2706 Critical Care and Intensive Care Medicine
medicine.medical_specialty
10216 Institute of Anesthesiology
Population
MEDLINE
610 Medicine & health
Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage [Medical Subject Headings]
Hierarchy of evidence
03 medical and health sciences
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatment::Resuscitation [Medical Subject Headings]
Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Blood Transfusion [Medical Subject Headings]
Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage::Shock, Hemorrhagic [Medical Subject Headings]
Intensive care medicine
education
Embolización terapéutica
Protocol (science)
business.industry
030208 emergency & critical care medicine
Guideline
medicine.disease
Técnicas hemostáticas
Transfusión Sanguínea
business
Factores de Tiempo
Sustitutos Sanguíneos
Subjects
Details
- ISSN :
- 13648535
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Critical Care
- Accession number :
- edsair.doi.dedup.....4fcc7866991c7eeea8817d211eac7b7e