INTRODUCTION: Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved. METHODS: The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. RESULTS: Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. CONCLUSIONS: A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond.
INTRODUCTION: Evidence-based recommendations are needed to guide the acute management of the bleeding traumapatient. When these recommendations are implemented patient outcomes may be improved. METHODS: The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. RESULTS: Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. CONCLUSIONS: A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond.
Authors: Nicholas Spoerke; Joel Michalek; Martin Schreiber; K J Brasel; G Vercruysse; J MacLeod; R P Dutton; J C Duchesne; N E McSwain; P Muskat; J Johannigamn; H M Cryer; A Tillou; M J Cohen; J F Pittet; P Knudson; M A De Moya; B Tieu; S Brundage; L M Napolitano; M Brunsvold; K C Sihler; A B Peitzman; M S Zenait; J Sperry; L Alarcon; M A Croce; J P Minei; R M Stewart; S M Cohn; J E Mickalek; E M Bulger; B A Cotton; T C Nunez; R Ivatury; J W Meredith; P Miller; G J Pomper; B Marin Journal: J Trauma Date: 2011-08
Authors: Lewis B Morgenstern; J Claude Hemphill; Craig Anderson; Kyra Becker; Joseph P Broderick; E Sander Connolly; Steven M Greenberg; James N Huang; R Loch MacDonald; Steven R Messé; Pamela H Mitchell; Magdy Selim; Rafael J Tamargo Journal: Stroke Date: 2010-07-22 Impact factor: 7.914
Authors: C R Valeri; G Cassidy; L E Pivacek; G Ragno; W Lieberthal; J P Crowley; S F Khuri; J Loscalzo Journal: Transfusion Date: 2001-08 Impact factor: 3.157
Authors: Scott A Chapman; Eric D Irwin; Alan L Beal; Nichole M Kulinski; Katherine E Hutson; Melissa A L Thorson Journal: Ann Pharmacother Date: 2011-07-20 Impact factor: 3.154
Authors: Ulrich Linsenmaier; Michael Krötz; Hannes Häuser; Clemens Rock; Johannes Rieger; Klaus Bohndorf; Klaus Jürgen Pfeifer; Maximilian Reiser Journal: Eur Radiol Date: 2001-12-13 Impact factor: 5.315
Authors: Meritxell Mellado; Javier Trujillo-Santos; Behnood Bikdeli; David Jiménez; Manuel Jesús Núñez; Martin Ellis; Pablo Javier Marchena; Jerónimo Ramón Vela; Albert Clara; Farès Moustafa; Manuel Monreal Journal: Intern Emerg Med Date: 2019-05-03 Impact factor: 3.397
Authors: V Albrecht; N Schäfer; E K Stürmer; A Driessen; L Betsche; M Schenk; M Maegele Journal: Eur J Trauma Emerg Surg Date: 2015-11-30 Impact factor: 3.693