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What's new for trauma haemorrhage management?
Paul Vulliamy1, Anthony J Thaventhiran2, Ross A Davenport3
1Clinical Lecturer and Specialist Registrar in General Surgery, Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London.
Abstract:
Uncontrolled haemorrhage is the leading cause of preventable death from injury and is a major contributor to the global burden of disease. The majority of deaths resulting from bleeding occur within the first 3 hours of hospital admission, and the window for meaningful intervention is therefore extremely small. Resuscitative efforts during active bleeding should focus on maintaining haemostatic function with blood product transfusion and early administration of tranexamic acid. Achieving control of haemorrhage is the overarching treatment priority and may require temporising measures before definitive surgical or radiological intervention. This review summarizes the contemporary approaches to resuscitation of bleeding trauma patients, options for achieving haemorrhage control, and current areas of active research including organ protective resuscitation and suspended animation.