[Multidisciplinary consensus document on the management of massive haemorrhage (HEMOMAS document)]

Area of Science:

• Medical Sciences
• Clinical Medicine
• Emergency Medicine

Background:

• Massive hemorrhage presents a significant clinical challenge, frequently leading to high morbidity and mortality rates.
• Existing evidence necessitates improvement and standardization in the management protocols for massive hemorrhage.

Purpose of the Study:

• To conduct a systematic literature review to extract recommendations for managing massive hemorrhage.
• To develop a multidisciplinary consensus document to standardize definitions and management strategies.

Main Methods:

• Systematic review of existing literature on massive hemorrhage management.
• Extraction of evidence-based recommendations.
• Development of a consensus document through multidisciplinary agreement.

Main Results:

• Agreement on definitions for massive hemorrhage and massive transfusion.
• Structured recommendations covering general management, including clinical assessment, hypothermia, fluid therapy, hypotensive resuscitation, and damage control surgery.
• Guidance on blood volume monitoring, transfusion ratios for red blood cells, fresh frozen plasma, and platelets.
• Recommendations for administering hemostatic components like prothrombin complex, fibrinogen, factor VIIa, and antifibrinolytic agents.

Conclusions:

• Standardized definitions and management protocols for massive hemorrhage are crucial.
• The consensus document provides a framework for improved clinical practice and patient outcomes.
• Multidisciplinary collaboration is key to effective hemorrhage management.