title: [Multidisciplinary consensus document on the management of massive haemorrhage (HEMOMAS document)].
abstract: Massive haemorrhage is common and often associated with high morbidity and mortality. We perform a systematic review of the literature, with extraction of the recommendations from the existing evidences because of the need for its improvement and the management standardization. From the results we found, we wrote a multidisciplinary consensus document. We begin with the agreement in the definitions of massive haemorrhage and massive transfusion, and we do structured recommendations on their general management (clinical assessment of bleeding, hypothermia management, fluid therapy, hypotensive resuscitation and damage control surgery), blood volume monitoring, blood products transfusion (red blood cells, fresh frozen plasma, platelets and their best transfusion ratio), and administration of hemostatic components (prothrombin complex, fibrinogen, factor VIIa, antifibrinolytic agents).
authors.affiliation: Anestesia y Reanimación, Hospital Clínico Universitario de Valencia, Valencia, España.
authors.forename: J V
authors.initials: JV
authors.lastname: Llau
authors.affiliation: Anestesia y Reanimación, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Acosta
authors.affiliation: Hemoterapia y Hematología, Hospital Clínic i Provincial de Barcelona, Barcelona, España.
authors.forename: G
authors.initials: G
authors.lastname: Escolar
authors.affiliation: Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Virgen de las Nieves; Instituto de Investigación Biosanitaria ibs.Granada, Granada, España. Electronic address: enrique.fernandez.mondejar.sspa@juntadeandalucia.es.
authors.forename: E
authors.initials: E
authors.lastname: Fernández-Mondéjar
authors.affiliation: Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Guasch
authors.affiliation: Hemoterapia y Hematología, Hospital General de Alicante, Alicante, España.
authors.forename: P
authors.initials: P
authors.lastname: Marco
authors.affiliation: Anestesia y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Paniagua
authors.affiliation: Hematología y Hemoterapia, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Páramo
authors.affiliation: Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Quintana
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Torrabadella
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D012151:Resuscitation / Q000009:adverse effects; D065227:Transfusion Reaction
chemical_list: D000933:Antifibrinolytic Agents
keywords: Blood component transfusion; Blood transfusion; Choque hemorrágico; Conferencia de consenso; Consenso; Consensus; Consensus development conference; Hemorragia; Hemorrhage; Plasma; Shock, Hemorrhagic; Transfusión de componentes sanguíneos; Transfusión sanguínea