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Multidisciplinary consensus document on the management of massive haemorrhage. First update 2023 (document

Juan V Llau1, César Aldecoa2, Emilia Guasch3

  • 1Anestesiología y Reanimación, Hospital Universitario Doctor Peset, València, Spain.

Revista Espanola De Anestesiologia Y Reanimacion
|August 28, 2023
PubMed
Summary

This updated guideline provides 41 evidence-based recommendations for managing massive hemorrhage, incorporating the latest research to improve patient outcomes in critical care settings.

Keywords:
Concentrado de hematíesFibrinogenFibrinógenoFresh plasmaHemorragia masivaMassive haemorrhagePlasma frescoRed blood cellsTest viscoelásticosTransfusionTransfusiónViscoelastic assay

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Area of Science:

  • Anesthesiology
  • Intensive Care Medicine
  • Hematology

Background:

  • The HEMOMAS document, first published in 2016, required an update to reflect advancements in massive hemorrhage management.
  • Endorsed by leading Spanish scientific societies, the original guideline aimed to standardize care for patients with severe bleeding.

Purpose of the Study:

  • To systematically review and update existing recommendations for the clinical management of massive hemorrhage.
  • To incorporate the latest evidence and adapt findings from recent guidelines published since 2014.

Main Methods:

  • Utilized elements of the ADAPTE methodology for guideline adaptation.
  • Conducted comprehensive literature searches in PubMed and EMBASE databases from January 2014 to June 2021.
  • Reviewed 9 existing guidelines and 207 selected articles to inform the update process.

Main Results:

  • Reviewed and revised all 47 recommendations from the original HEMOMAS document.
  • Resulted in a final set of 41 updated recommendations for massive hemorrhage management.
  • Recommendations were modified, retained, or deleted based on current evidence and expert consensus.

Conclusions:

  • The updated guideline offers current, evidence-based recommendations for managing massive hemorrhage.
  • These revised recommendations aim to optimize patient care and outcomes in critical bleeding situations.
  • The consensus-driven approach ensures the clinical applicability and acceptance of the updated management strategies.