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[Management of massive bleeding in 2013: seven questions and answers].

Abstract
The management of massive bleeding has improved, thanks to high-quality blood components and new transfusion strategies. However, it remains controversial and, despite a huge body of literature, randomised control trials are still lacking. However, the therapeutic approach has also evolved, requiring earlier and more active management. If a 'no delay' management is well recognized, its modes are still discussed. Immediate delivery of blood products with ratios close to 1:1:1 for RBC units/fresh frozen plasma/platelet concentrates, through massive transfusion protocol using blood packs, has been advocated, but yet this approach is not evidence-based. Secondly, a targeted strategy to provide fibrinogen concentrates is under evaluation. Tranexamic acid is effective in trauma patients. Recombinant factor VIIa should only be used on a compassionate basis.
AuthorsA Godier, C M Samama, S Susen
JournalTransfusion clinique et biologique : journal de la Société française de transfusion sanguine (Transfus Clin Biol) Vol. 20 Issue 2 Pg. 55-8 (May 2013) ISSN: 1953-8022 [Electronic] France
Vernacular TitlePrise en charge en 2013 de l'hémorragie aiguë massive: réponses à sept questions.
PMID23587620 (Publication Type: English Abstract, Journal Article)
CopyrightCopyright © 2013 Elsevier Masson SAS. All rights reserved.
Chemical References
  • Hemostatics
  • Recombinant Proteins
  • recombinant FVIIa
  • Tranexamic Acid
  • Fibrinogen
  • Factor VIIa
Topics
  • Acute Disease
  • Blood Component Transfusion (methods, trends)
  • Combined Modality Therapy
  • Disease Management
  • Erythrocyte Transfusion
  • Factor VIIa (therapeutic use)
  • Female
  • Fibrinogen (therapeutic use)
  • Hemorrhage (drug therapy, therapy)
  • Hemostatics (therapeutic use)
  • Humans
  • Plasma
  • Postoperative Hemorrhage (therapy)
  • Postpartum Hemorrhage (therapy)
  • Pregnancy
  • Recombinant Proteins (therapeutic use)
  • Tranexamic Acid (therapeutic use)

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