在创伤室的复苏和护理
Jan-Michael Van Gent1, Thomas W Clements1, Bryan A Cotton2
1The Red Duke Trauma Institute, Memorial Hermann Hospital, Houston, TX, USA; McGovern Medical School, University of Texas Health Science Center-Houston, Houston, TX, USA.
The Surgical clinics of North America
|March 7, 2024
概括
使用全血或1:1:1比率的早期平衡复苏可最大限度地减少创伤引起的凝血病并改善患者的治疗结果. 尽量减少结晶体的使用,并使用协议化输血触发器,以便及时有效地治疗创伤.
科学领域:
- 创伤复苏的复苏治疗方法
- 流血性休克管理的管理.
- 凝血病治疗方法 凝血病治疗方法
背景情况:
- 创伤引起的凝血病 (TIC) 显著增加了发病率和死亡率.
- 结晶体主导的复苏策略可能会使创伤患者的结果恶化.
- 早期干预对于预防不可逆转的凝血病至关重要.
研究的目的:
- 概述早期创伤复苏的最佳策略.
- 强调平衡的复苏和早期输血的好处.
- 为指导用于管理凝血病的辅助剂的使用.
主要方法:
- 早期启动平衡复苏 (全血或1:1:1比).
- 尽量减少水晶体的使用.
- 实施协议化触发器进行大规模输血.
- 通过粘弹性测试和实验室结果指导进一步的复苏.
- 使用诸如,酸和纤维素原等辅助剂.
主要成果:
- 均衡的复苏有效地避免了创伤引起的凝血病.
- 早期全血输血可以降低患者的发病率和死亡率.
- 协议化输血触发器最大限度地减少了延迟,并确保了均衡的产品比率.
- 粘弹性测试指导适当的辅助和血液产品的替代.
结论:
- 早期平衡复苏是预防和管理创伤引起的凝血病的关键.
- 最小化晶体和优化血液产品比率提高了生存率.
- 协议化方法和粘弹性测试提高了复苏的有效性.
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