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.
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Authors | A Godier, C M Samama, S Susen |
Journal | Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine
(Transfus Clin Biol)
Vol. 20
Issue 2
Pg. 55-8
(May 2013)
ISSN: 1953-8022 [Electronic] France |
Vernacular Title | Prise en charge en 2013 de l'hémorragie aiguë massive: réponses à sept questions. |
PMID | 23587620
(Publication Type: Journal Article)
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Copyright | Copyright © 2013 Elsevier Masson SAS. All rights reserved. |
Chemical References |
- Hemostatics
- Recombinant Proteins
- Tranexamic Acid
- Fibrinogen
- recombinant FVIIa
- Factor VIIa
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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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