title: Resuscitative goals and new strategies in severe trauma patient resuscitation.
abstract: Traumatic injuries represent a major health problem all over the world. In recent years we have witnessed profound changes in the paradigm of severe trauma patient resuscitation, new concepts regarding acute coagulopathy in trauma have been proposed, and there has been an expansion of specific commercial products related to hemostasis, among other aspects. New strategies in severe trauma management include the early identification of those injuries that are life threatening and require surgical hemostasis, tolerance of moderate hypotension, rational intravascular volume replacement, prevention of hypothermia, correction of acidosis, optimization of oxygen carriers, and identification of those factors required by the patient (fresh frozen plasma, platelets, tranexamic acid, fibrinogen, cryoprecipitates and prothrombin complex). However, despite such advances, further evidence is required to improve survival rates in severe trauma patients.
authors.affiliation: Unidad de Neurocríticos. Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina (IBiS)/CSIC Universidad de Sevilla, Sevilla, España. Electronic address: juanjoegea@hotmail.com.
authors.forename: J J
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.affiliation: Unidad de Neurocríticos. Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: M D
authors.initials: MD
authors.lastname: Freire-Aragón
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Serrano-Lázaro
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitario de La Paz, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Quintana-Díaz
mesh_terms: D000138:Acidosis / Q000209:etiology / Q000517:prevention & control; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000628:therapy; D016913:Blood Component Transfusion; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods; D006040:Goals; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy; D007035:Hypothermia / Q000209:etiology / Q000517:prevention & control; D007813:Laparotomy / Q000379:methods; D012151:Resuscitation / Q000379:methods*; D012769:Shock / Q000209:etiology / Q000517:prevention & control; D014947:Wounds and Injuries / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
chemical_list: D006490:Hemostatics
keywords: Coagulopathy; Coagulopatía; Goals; Intensive Care Unit; Lesiones traumáticas; Objetivos; Transfusion; Transfusión; Traumatic injuries; Unidad de Cuidados Intensivos