A comprehensive review of massive transfusion and major hemorrhage protocols: origins, core principles and practical implementation.

ABSTRACT: Until the beginning of the century, bleeding management was similar in elective surgeries or exsanguination scenarios: clotting tests were used to guide blood product orders and, while awaiting these results, an aggressive resuscitation with crystalloids was recommended. The high mortality rate in severe hemorrhages managed with this strategy endorsed the need for a special resuscitation plan. As a result, modifications were recommended to develop a new clinical approach to these patients, called "Damage Control Resuscitation". This strategy includes four principles: damage control surgery, minimization of crystalloids, permissive hypotension and hemostatic resuscitation. The latter involves the use of antifibrinolytics, correction of preconditions of hemostasis (calcium, pH and temperatur

SUBMITTER: Marinho DS 

PROVIDER: S-EPMC11808514 | biostudies-literature | 2024 Dec

REPOSITORIES: biostudies-literature