需要大量输血的受伤患者的复苏:个人的观点
1From the Department of Surgery, Detroit Receiving Hospital, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan.
The journal of trauma and acute care surgery
|May 9, 2024
概括
本综述研究了经历出血性休克 (HS) 的重大创伤患者的复苏策略. 它总结了65年的临床经验,大规模输血协议及其相关争议.
科学领域:
- 创伤外科 手术 创伤外科
- 复苏医学 复苏医学 复苏医学
- 血液性冲击管理 血液性冲击管理
背景情况:
- 在过去的一个世纪里,在复苏方面取得了重大进展.
- 严重创伤后的出血性休克 (HS) 需要大量输血 (>10 U/24h).
- 对于这些严重受伤的患者来说,最佳的复苏策略仍然是争论的主题.
研究的目的:
- 审查和总结HS重创患者的复苏争议.
- 巩固几十年关于大规模输血协议的临床经验.
- 分析各种复苏组件的证据,包括血液制品,液体和药物.
主要方法:
- 对65年来临床经验和文献的回顾.
- 专注于一个创伤外科医生在繁忙的城市急症中心的观察.
- 对新鲜全血,储存血液,血,血小板,合体,晶体体,血管压缩剂和利尿剂的建议进行分析.
主要成果:
- 在HS患者的复苏中确定了许多经常相矛盾的建议.
- 突出了大规模输血协议的复杂性和不断变化的性质.
- 综合了广泛的干预措施及其辩论的角色.
结论:
- 重度创伤患者经历出血性休克的复苏涉及复杂的,往往相互矛盾的证据.
- 长期的临床经验为管理大规模输血提供了宝贵的见解.
- 需要进一步的研究来解决创伤复苏中持续存在的争议.
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