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Báo cáo y học: "The contemporary role of blood products and components used in trauma resuscitation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The contemporary role of blood products and components used in trauma resuscitation | Dries Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 63 http www.sjtrem.eom content 18 1 63 SCANDINAVIAN JOURNAL OF t emergency medicine REVIEW Open Access The contemporary role of blood products and components used in trauma resuscitation David J Dries Abstract Introduction There is renewed interest in blood product use for resuscitation stimulated by recent military experience and growing recognition of the limitations of large-volume crystalloid resuscitation. Methods An editorial review of recent reports published by investigators from the United States and Europe is presented. There is little prospective data in this area. Results Despite increasing sophistication of trauma care systems hemorrhage remains the major cause of early death after injury. In patients receiving massive transfusion defined as 10 or more units of packed red blood cells in the first 24 hours after injury administration of plasma and platelets in a ratio equivalent to packed red blood cells is becoming more common. There is a clear possibility of time dependent enrollment bias. The early use of multiple types of blood products is stimulated by the recognition of coagulopathy after reinjury which may occur as many as 25 of patients. These patients typically have large-volume tissue injury and are acidotic. Despite early enthusiasm the value of administration of recombinant factor VIIa is now in question. Another dilemma is monitoring of appropriate component administration to control coagulopathy. Conclusion In patients requiring large volumes of blood products or displaying coagulopathy after injury it appears that early and aggressive administration of blood component therapy may actually reduce the aggregate amount of blood required. If recombinant factor VIIa is given it should be utilized in the fully resuscitated patient. Thrombelastography is seeing increased application for real-time assessment of coagulation changes after injury and directed .