Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

How I treat patients with massive hemorrhage

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Clonal hematopoiesis in elderly twins: concordance, discordance and mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Skin colonization by circulating neoplastic clones in cutaneous T-cell lymphoma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Low vs. high hemoglobin trigger for Transfusion in Vascular surgery (TV): a randomized clinical feasibility trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Short regimen of rituximab plus lenalidomide in follicular lymphoma patients in need of first-line therapy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. The preleukemic TCF3-PBX1 gene fusion can be generated in utero and is present in ≈0.6% of healthy newborns

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

Vis graf over relationer

Massive hemorrhage is associated with coagulopathy and high mortality. The transfusion guidelines up to 2006 recommended that resuscitation of massive hemorrhage should occur in successive steps using crystalloids, colloids and red blood cells (RBC) in the early phase, and plasma and platelets in the late phase. With the introduction of the cell-based model of hemostasis in the mid 1990ties, our understanding of the hemostatic process and of coagulopathy has improved. This has contributed to a change in resuscitation strategy and transfusion therapy of massive hemorrhage along with an acceptance of the adequacy of whole blood hemostatic tests to monitor these patients. Thus, in 2005, a strategy aiming at avoiding coagulopathy by pro-active resuscitation with blood products in a balanced ratio of RBC:plasma:platelets was introduced and this has been reported to be associated with reduced mortality in observational studies. Concurrently, whole blood viscoelastic hemostatic assays (VHA) have gained acceptance by allowing a rapid and timely identification of coagulopathy along with enabling an individualized, goal-directed transfusion therapy. These strategies joined together seem beneficial for patient outcome, although final evidence on outcome from randomized controlled trials are lacking. We here present how we in Copenhagen and Houston, today, manage patients with massive hemorrhage.

OriginalsprogEngelsk
TidsskriftBlood
Vol/bind124
Udgave nummer20
Sider (fra-til)3052-8
ISSN0006-4971
DOI
StatusUdgivet - 7 okt. 2014

ID: 44608083