Whole Blood, Fixed Ratio, or Goal-Directed Blood Component Therapy for the Initial Resuscitation of Severely Hemorrhaging Trauma Patients: A Narrative Review

This narrative review explores the pathophysiology, geographic variation, and historical developments underlying the selection of fixed ratio versus whole blood resuscitation for hemorrhaging trauma patients. We also detail a physiologically driven and goal-directed alternative to fixed ratio and wh...

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Detalles Bibliográficos
Autores principales: Walsh, Mark, Moore, Ernest E., Moore, Hunter B., Thomas, Scott, Kwaan, Hau C., Speybroeck, Jacob, Marsee, Mathew, Bunch, Connor M., Stillson, John, Thomas, Anthony V., Grisoli, Annie, Aversa, John, Fulkerson, Daniel, Vande Lune, Stefani, Sjeklocha, Lucas, Tran, Quincy K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830337/
https://www.ncbi.nlm.nih.gov/pubmed/33477257
http://dx.doi.org/10.3390/jcm10020320
Descripción
Sumario:This narrative review explores the pathophysiology, geographic variation, and historical developments underlying the selection of fixed ratio versus whole blood resuscitation for hemorrhaging trauma patients. We also detail a physiologically driven and goal-directed alternative to fixed ratio and whole blood, whereby viscoelastic testing guides the administration of blood components and factor concentrates to the severely bleeding trauma patient. The major studies of each resuscitation method are highlighted, and upcoming comparative trials are detailed.

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