Posttraumatic massive bleeding: a challenging multidisciplinary task.
Massive bleeding is a key issue in the treatment of trauma and surgery. It does in fact account for more than 50% of all trauma-related deaths within the first 48 h following hospital admission, and it can significantly raise the mortality rate of any kind of surgery. Despite this great clinical relevance, evidence on the management of massive bleeding is surprisingly scarce, and its treatment is often based on empirical grounds. Successful treatment of massive haemorrhage depends on better understanding of the associated physiological changes as well as on good team work between the different specialists involved in the management of such a complex condition. The aim of this article is to provide an overview of the pathophysiology as well as of current treatment options of such a condition, including the new concept of "damage control resuscitation", which integrates permissive hypotension, haemostatic resuscitation and damage control surgery.
Marietta
Marco
M
Dipartimento Integrato di Oncologia, Ematologia e Patologie dell'Apparto Respiratorio, U.O.C. di Ematologia, Ospedale Policlinico, Azienda Ospedaliero-Universitaria Policlinico di Modena, via del Pozzo 71, 41100 Modena, Italy. marietta@unimo.it
Pedrazzi
Paola
P
Girardis
Massimo
M
Busani
Stefano
S
Torelli
Giuseppe
G
D016913:Blood Component Transfusion; D001792:Blood Platelets; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D009104:Multiple Trauma / Q000150:complications*; D010102:Oxygen Inhalation Therapy; D010348:Patient Care Team; D010949:Plasma
D006490:Hemostatics