Nonsurgical techniques to control massive bleeding.
Significant advancements in nonsurgical and surgical approaches to control bleeding in severely injured patients have also improved the treatment of critical trauma-related coagulopathy. Nonsurgical procedures such as angiographic embolization are progressively considered to terminate arterial bleeding from pelvic fractures. The disturbance of coagulation may aggravate bleeding and hamper surgical procedures. The administration of coagulation factors and factor concentrates may be useful for correcting systemic coagulopathy and reducing the need for fresh frozen plasma, platelet, and red blood cell transfusions, which are associated with various adverse outcomes. In this review, nonsurgical management of critical trauma bleeding is discussed.
Department of Anesthesiology, RWTH Aachen University Hospital, Aachen, Germany. czentai@ukaachen.de
Christian
C
Zentai
Oliver
O
Grottke
Donat R
DR
Spahn
Rolf
R
Rossaint
D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000379:methods; D015942:Factor VIIa / Q000627:therapeutic use; D005340:Fibrinogen / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D014111:Tourniquets; D014947:Wounds and Injuries / Q000628:therapy*
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; C025667:prothrombin complex concentrates; D005340:Fibrinogen; D015942:Factor VIIa