[Prevention and therapy of hemostatic disorders in massive transfusion].
Adequate periop. analysis of hemostasis taking into account also disorders of primary hemostasis considerably contributes to prevention, early detection and appropriate treatment of hemostatic disturbances. Standard transfusion protocols are advisable in massive transfusion with respect to logistic problems. We describe an effective standard protocol based on the initial administration of blood components (red cells, plasma, platelets) in a certain fixed ratio which then is adapted according to the laboratory test results and the clinical situation of the patient. In addition, as soon as the hemostasis shows critical values, coagulation factor concentrates (prothrombin complex, fibrinogen, seldom single coagulation factors) are administered. Furthermore, desmopressin and antifibrinolytics can be successfully used in disorders of primary hemostasis, and additionally antifibrinolytics in hyperfibrinolysis or unclear diffuse bleeding.
Kretschmer
V
V
Institut für Transfusionsmedizin und Hämostaseologie, Universitätsklinikum, Conradistrasse, 35033 Marburg.
Haas
C
C
Weippert-Kretschmer
M
M
D000328:Adult; D001779:Blood Coagulation Factors / Q000008:administration & dosage*; D016913:Blood Component Transfusion; D001810:Blood Volume / Q000502:physiology; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage; D005342:Fibrinolysis / Q000187:drug effects; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D019990:Perioperative Care
D001779:Blood Coagulation Factors; D003894:Deamino Arginine Vasopressin