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Management of bleeding following major trauma: a European guideline

dc.contributor.authorSpahn, Donat R
dc.contributor.authorCerny, Vladimir
dc.contributor.authorCoats, Timothy J
dc.contributor.authorDuranteau, Jacques
dc.contributor.authorFernández-Mondéjar, Enrique
dc.contributor.authorGordini, Giovanni
dc.contributor.authorStahel, Philip F
dc.contributor.authorHunt, Beverley J
dc.contributor.authorKomadina, Radko
dc.contributor.authorNeugebauer, Edmund
dc.contributor.authorOzier, Yves
dc.contributor.authorRiddez, Louis
dc.contributor.authorSchultz, Arthur
dc.contributor.authorVincent, Jean-Louis
dc.contributor.authorRossaint, Rolf
dc.contributor.authoraffiliation[Spahn,DR] Department of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. [Cerny,V] Charles University in Prague, Faculty of Medicine in Hradec Králové, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic. [Coats,TJ] Leicester Royal Infirmary, Accident and Emergency Department, Leicester,UK. [Duranteau,J] Department of Anaesthesia and Intensive Care, University of Paris XI Faculté de Médecine Paris-Sud,Le Kremlin-Bicêtre, France. [Fernández-Mondéjar,E] Department of Emergency and Critical Care Medicine, University Hospital Virgen de las Nieves, Granada, Spain. [Gordini,G] Department of Anaesthesia and Intensive Care, Ospedale Maggiore, Bologna, Italy. [ Stahel,PF] Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado Medical School, Denver, USA. [Hunt,BJ] Departments of Haematology, Pathology and Rheumatology, Guy's & St Thomas' Foundation Trust, London, UK. [Komadina,R] Department of Traumatology, General and Teaching Hospital Celje, Celje, Slovenia. [Neugebauer,E] Institute for Research in Operative Medicine, University of Witten/Herdecke, Köln (Merheim), Germany. [Ozier,Y] Department of Anaesthesia and Intensive Care, Université René Descartes, Paris, Hopital Cochin, Paris, France. [Riddez,L] Department of Surgery and Trauma, Karolinska University Hospital, Solna, Sweden. [Schultz,A] Ludwig-Boltzmann-Institute for Experimental and Clinical Traumatology, Vienna, Austria. [Vincent,JL] Department of Intensive Care, Erasme Hospital, University of Brussels, Belgium, Brussels, Belgium. [Rossaint,R] Department of Anaesthesiology, University Hospital Aachen, Aachen, Germany.es
dc.contributor.funderMeeting organisation and medical writing support for literature searches and manuscript preparation were provided by Thomson Physicians World GmbH. Costs incurred for travel, hotel accommodations, meeting facilities, honoraria, and preparation of the guidelines were supported by unrestricted educational grants from Novo Nordisk AG (Zurich, Switzerland).
dc.date.accessioned2012-12-13T10:57:38Z
dc.date.available2012-12-13T10:57:38Z
dc.date.issued2007-02-13
dc.descriptionJournal Article; Practice Guideline;es
dc.description.abstractINTRODUCTION Evidence-based recommendations can be made with respect to many aspects of the acute management of the bleeding trauma patient, which when implemented may lead to improved patient outcomes. METHODS The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing guidelines for the management of bleeding following severe injury. Recommendations were formulated using a nominal group process and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) hierarchy of evidence and were based on a systematic review of published literature. RESULTS Key recommendations include the following: The time elapsed between injury and operation should be minimised for patients in need of urgent surgical bleeding control, and patients presenting with haemorrhagic shock and an identified source of bleeding should undergo immediate surgical bleeding control unless initial resuscitation measures are successful. A damage control surgical approach is essential in the severely injured patient. Pelvic ring disruptions should be closed and stabilised, followed by appropriate angiographic embolisation or surgical bleeding control, including packing. Patients presenting with haemorrhagic shock and an unidentified source of bleeding should undergo immediate further assessment as appropriate using focused sonography, computed tomography, serum lactate, and/or base deficit measurements. This guideline also reviews appropriate physiological targets and suggested use and dosing of blood products, pharmacological agents, and coagulation factor replacement in the bleeding trauma patient. CONCLUSION A multidisciplinary approach to the management of the bleeding trauma patient will help create circumstances in which optimal care can be provided. By their very nature, these guidelines reflect the current state-of-the-art and will need to be updated and revised as important new evidence becomes available.es
dc.description.versionYeses
dc.identifier.citationSpahn DR, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, Gordini G et al.Management of bleeding following major trauma: a European guideline. Crit Care. 2007;11(1):R17.es
dc.identifier.doi10.1186/cc5686
dc.identifier.essn1466-609X
dc.identifier.issn1364-8535
dc.identifier.pmcPMC2151863
dc.identifier.pmid17298665
dc.identifier.urihttp://hdl.handle.net/10668/715
dc.journal.titleCritical care
dc.language.isoen
dc.publisherBioMed Centrales
dc.relation.publisherversionhttp://ccforum.com/content/11/1/R17es
dc.rights.accessRightsopen access
dc.subjectBlood Substituteses
dc.subjectTrastornos de la coagulación sanguíneaes
dc.subjectSustitutos sanguíneoses
dc.subjectTransfusión sanguíneaes
dc.subjectEmbolización terapéuticaes
dc.subjectTratamiento de urgenciaes
dc.subjectHemorragiaes
dc.subjectTécnicas hemostáticases
dc.subjectHumanoses
dc.subjectResucitaciónes
dc.subjectChoque hemorrágicoes
dc.subjectFactores de Tiempoes
dc.subjectHeridas y Traumatismoses
dc.subjectCuestionarioses
dc.subjectTrastornos Somatosensorialeses
dc.subjectEspañaes
dc.subjectSíndromees
dc.subjectTraduccioneses
dc.subjectAntifibrinolytic Agentses
dc.subject.meshMedical Subject Headings::Diseases::Hemic and Lymphatic Diseases::Hematologic Diseases::Blood Coagulation Disorderses
dc.subject.meshMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Blood Substituteses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Blood Transfusiones
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Hemostatic Techniques::Embolization, Therapeutices
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatmentes
dc.subject.meshMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhagees
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Hemostatic Techniqueses
dc.subject.meshMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humanses
dc.subject.meshMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatment::Resuscitationes
dc.subject.meshMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage::Shock, Hemorrhagices
dc.subject.meshMedical Subject Headings::Phenomena and Processes::Physical Phenomena::Time::Time Factorses
dc.subject.meshMedical Subject Headings::Diseases::Wounds and Injurieses
dc.titleManagement of bleeding following major trauma: a European guidelinees
dc.typeresearch article
dc.type.hasVersionVoR
dspace.entity.typePublication
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