Management of bleeding and coagulopathy following major trauma: an updated European guideline
Year: 2013
Type: article
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.
Source: Critical Care
DOI: 10.1186/cc12685
Institutions: University Hospital Zurich, Witten/Herdecke University, Dalhousie University, University Hospital Hradec Králové, University of Leicester, Université Paris-Sud, Hospital Universitario Virgen de las Nieves, Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu", Guy's and St Thomas' NHS Foundation Trust, Centre Hospitalier Régional Universitaire de Brest, Karolinska University Hospital, Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation with AUVA, Université Libre de Bruxelles, Erasmus Hospital, Universitätsklinikum Aachen, RWTH Aachen University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
Funders: National Science Foundation, Amgen, Eli Lilly and Company, Pfizer, GlaxoSmithKline, Sanofi, Univerzita Karlova v Praze, CSL Behring, Swiss Foundation for Anesthesia Research, Société Suisse d'Anesthésie et Réanimation, University of Leicester, Bayer HealthCare, College of Emergency Medicine, Deutsche Forschungsgemeinschaft, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Bundesministerium für Bildung und Forschung, Secrétariat Général pour les Affaires Régionales, Etat en Région Aquitaine, Novo Nordisk, Université Paris-Sud, Servier
OpenAlex ID: W2111374185