[Haemostatic resuscitation in bleeding trauma patients]

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Trauma hemorrhage is a leading reversible cause of death.
• Effective hemostatic resuscitation is vital for patient survival.
• Current transfusion strategies aim to rapidly restore oxygen-carrying capacity and hemostasis.

Purpose of the Study:

• To outline the principles and components of modern hemostatic resuscitation.
• To describe the optimal transfusion ratio and adjunct therapies used in Denmark for massive bleeding.

Main Methods:

• Implementing a balanced transfusion strategy with a 1:1:1 ratio of red blood cells, plasma, and platelets.
• Restricting the use of crystalloid fluids.
• Administering tranexamic acid early in the resuscitation process.
• Utilizing viscoelastic hemostatic assays for goal-directed therapy.

Main Results:

• The described hemostatic resuscitation protocol aims to optimize coagulopathy management.
• Early intervention with balanced blood products and adjuncts can improve outcomes in massive hemorrhage.

Conclusions:

• Hemostatic resuscitation, including a 1:1:1 transfusion ratio, restricted crystalloids, early tranexamic acid, and goal-directed therapy, is essential for managing trauma hemorrhage.
• This comprehensive approach addresses both oxygen delivery and coagulopathy, aiming to reduce mortality.