Rossaint, RolfBouillon, BertilCerny, VladimirCoats, Timothy JDuranteau, JacquesFernández-Mondéjar, EnriqueHunt, Beverley JKomadina, RadkoNardi, GiuseppeNeugebauer, EdmundOzier, YvesRiddez, LouisSchultz, ArthurStahel, Philip FVincent, Jean-LouisSpahn, Donat R2015-12-292015-12-292010-04-06Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, et al. Management of bleeding following major trauma: an updated European guideline. Crit Care. 2010; 14(2):R52http://hdl.handle.net/10668/2118Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't;INTRODUCTION Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient, which when implemented may improve patient outcomes. 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 presents an updated version of the guideline published by the group in 2007. 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 coagulation support and monitoring and the appropriate use of local haemostatic measures, tourniquets, calcium and desmopressin in the bleeding trauma patient. The remaining recommendations have been reevaluated 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 This guideline provides an evidence-based multidisciplinary approach to the management of critically injured bleeding trauma patients.enEuropa (Continente)Medicina basada en la evidenciaFluidoterapiaTécnicas hemostáticasChoque hemorrágicoÍndices de gravedad del traumaTratamiento de urgenciaMedical Subject Headings::Geographicals::Geographic Locations::EuropeMedical Subject Headings::Disciplines and Occupations::Health Occupations::Evidence-Based Practice::Evidence-Based MedicineMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Fluid TherapyMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Hemostatic TechniquesMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Hemorrhage::Shock, HemorrhagicMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Trauma Severity IndicesMedical Subject Headings::Diseases::Wounds and InjuriesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatmentresearch article20370902open access10.1186/cc89431466-609XPMC2887168