Management of Bleeding Following Major Trauma: an Updated European Guideline

Overview

Journal Crit Care

Specialty Critical Care

Date 2010 Apr 8

PMID 20370902

Citations 175

Authors

Rolf Rossaint

Bertil Bouillon

Vladimir Cerny

Timothy J Coats

Jacques Duranteau

Enrique Fernandez-Mondejar

Beverley J Hunt

Radko Komadina

Giuseppe Nardi

Edmund Neugebauer

Yves Ozier

Louis Riddez

Arthur Schultz

Philip F Stahel

Jean-Louis Vincent

Donat R Spahn

Affiliations

Soon will be listed here.

Abstract

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.

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