Transfusion strategies for major haemorrhage in trauma.
Nicola S CurryRoss DavenportPublished in: British journal of haematology (2018)
Trauma is a leading cause of death worldwide in persons under 44 years of age, and uncontrolled haemorrhage is the most common preventable cause of death in this patient group. The transfusion management of trauma haemorrhage is unrecognisable from 20 years ago. Changes in clinical practice have been driven primarily by an increased understanding of the pathophysiology of trauma-induced coagulopathy (TIC), which is associated with poor clinical outcomes, including a 3- to 4-fold increased risk of death. Targeting this coagulopathy alongside changes to surgical and anaesthetic practices (an overarching strategy known as damage control surgery/damage control resuscitation) has led to a significant reduction in mortality rates over the last two decades. This narrative review will discuss the transfusion practices that are currently used for trauma haemorrhage and the evidence that supports these practices.
Keyphrases
- trauma patients
- primary care
- healthcare
- cardiac surgery
- clinical practice
- cardiac arrest
- oxidative stress
- minimally invasive
- emergency department
- sickle cell disease
- cardiovascular disease
- acute kidney injury
- case report
- type diabetes
- coronary artery disease
- cardiovascular events
- cancer therapy
- high glucose
- coronary artery bypass
- acute coronary syndrome
- cardiopulmonary resuscitation
- septic shock
- adverse drug
- electronic health record
- deep brain stimulation