Universität zu Köln

Caspers, Michael, Maegele, Marc and Froehlich, Matthias (2018). Current strategies for hemostatic control in acute trauma hemorrhage and trauma-induced coagulopathy. Expert Rev. Hematol., 11 (12). S. 987 - 996. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1747-4094

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Abstract

Introduction: Despite advances in the treatment of severely injured patients that have resulted in overall improved outcomes, uncontrolled hemorrhage still represents the most common cause of preventable death following major injury. While addressing both endo- and exogenous factors that lead to an acute trauma-induced coagulopathy, massive transfusion plays a key role in managing bleeding trauma patients. However, the best practice for hemostatic control including massive transfusion in these patients is still under debate. Areas covered: This review summarizes the current knowledge and clinical practice for hemostatic control including massive transfusion for bleeding trauma patients. The recent literature was reviewed and extended by current guidelines and their underlying evidence was incorporated. Expert commentary: Treatment strategies for bleeding trauma patients are still an area of emerging scientific and clinical interest as advances are likely to translate into improved outcomes including survival. To date, damage control resuscitation principles with ratio-based transfusion of packed red blood cells, plasma and platelets still dominate as gold standard of care but goal-directed strategies guided either by conventional coagulation tests or viscoelastic assays may demonstrate a better characterization of the underlying coagulopathy thereby allowing individualized and targeted therapies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Caspers, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Maegele, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Froehlich, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-162478
DOI:	10.1080/17474086.2018.1548929
Journal or Publication Title:	Expert Rev. Hematol.
Volume:	11
Number:	12
Page Range:	S. 987 - 996
Date:	2018
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1747-4094
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DAMAGE-CONTROL RESUSCITATION; RECEIVING MASSIVE TRANSFUSIONS; VASCULAR OCCLUSIVE EVENTS; SEVERELY INJURED PATIENTS; ACTIVATED FACTOR-VII; TRANEXAMIC ACID; THROMBOELASTOMETRY ROTEM(R); COAGULATION COMPETENCE; PRACTICE MANAGEMENT; BLOOD-TRANSFUSION Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16247