Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

How I treat patients with massive hemorrhage

Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

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

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Prehospital plasma is associated with distinct biomarker expression following injury

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Biomarkers in patients with Takotsubo cardiomyopathy compared to patients with acute anterior ST-elevation myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Endothelial glycocalyx shedding in patients with burns

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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.

Original languageEnglish
JournalBlood
Volume124
Issue number20
Pages (from-to)3052-8
ISSN0006-4971
DOIs
Publication statusPublished - 7 Oct 2014

ID: 44608083