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Updated: May 25, 2026
04:20
A Saline/Bipolar Radiofrequency Energy Device As an Adjunct for Hemostasis in Solid Organ Injury/Trauma
Published on: July 28, 2020
[Treatment alternatives in massive hemorrhage]
E Fernández-Hinojosa1, F Murillo-Cabezas, A Puppo-Moreno
1Servicio de Cuidados Críticos, Hospital Universitario Virgen del Rocío, Sevilla, España.
Medicina Intensiva
|February 11, 2012
Summary
Massive hemorrhage management involves controlled crystalloid use and a 1:1:1 ratio of red cells, plasma, and platelets. Thromboelastography can guide treatment for trauma and surgical bleeding patients.
Area of Science:
- Trauma and Surgical Critical Care
- Hemorrhage Management
- Transfusion Medicine
Context:
- Massive hemorrhage is a leading cause of death in trauma and major surgery patients.
- Conventional treatments focus on volume replacement and blood product transfusion.
- The lethal triad of hypothermia, acidosis, and coagulopathy complicates patient outcomes.
Purpose:
- To review the latest therapeutic strategies for managing massive hemorrhage.
- To advocate for protocolized crystalloid administration and balanced blood product transfusion.
- To highlight the role of point-of-care thromboelastography in guiding treatment.
Summary:
- This review advocates for controlled crystalloid administration to maintain a systolic blood pressure of 85mmHg.
- A 1:1:1 ratio of red blood cells, plasma, and platelets is recommended for transfusion.
- Thromboelastography is encouraged for guiding transfusion strategies when available.
- The management of early and late coagulopathy is discussed, with tranexamic acid noted as an exception among hemostatic agents.
Impact:
- Provides updated guidelines for managing life-threatening bleeding in critical care settings.
- Emphasizes evidence-based strategies to improve patient survival and reduce morbidity.
- Informs clinicians on the appropriate use of blood products and monitoring tools.
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