SynthesisCritical care (London, England)2011
The acute management of trauma hemorrhage: a systematic review of randomized controlled trials.
Synthesis in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Prehospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Review article: Early steroid administration for traumatic haemorrhagic shock: A systematic review.Emergency medicine Australasia : EMA · 2023Pooled it
- Prehospital Blood Product Resuscitation for Trauma: A Systematic Review.Shock (Augusta, Ga.) · 2016Pooled it
- Emergency ultrasound-based algorithms for diagnosing blunt abdominal trauma.The Cochrane database of systematic reviews · 2015Pooled it
- Cell salvage in emergency trauma surgery.The Cochrane database of systematic reviews · 2015Pooled it
- Risk factors for blood transfusion in traumatic and postpartum hemorrhage patients: Analysis of the CRASH-2 and WOMAN trials.PloS one · 2020Trial
- Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial.Trials · 2017Trial
- Under pressure - a sensor-based analysis of simulated prehospital pressure dressing application for hemorrhage management.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Operative burden and resuscitation resource utilisation in patients with traumatic shock requiring urgent surgical or endovascular intervention.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Optimal fibrinogen threshold in non-traumatic massive bleeding: a multicenter retrospective observational study.Critical care (London, England) · 2026Observational
- Scalable bioreactor manufacturing of iPSC-derived megakaryocytes with Proanthocyanidin A supplementation: a strategic platform for military blood supply resilience.Military Medical Research · 2026Article
- Construction and verification of an early warning model for hypothermia in emergency trauma patients based on the random forest method.American journal of translational research · 2026Article
- Point-of-care treatment of acute skin wound by portable in-situ electrospinning nanofiber dressings with rapid hemostasis, anti-infection, and angiogenesis effects.Bioactive materials · 2025Article
- Development and Characterization of Effective Hemostatic Composites Based on Polyvinyl Alcohol/Kaolinite/Chitosan.Polymers · 2025Article
- Chlorocatechol-functionalized gelatin nanoparticles as a hemostatic agent with antimicrobial properties.Acta biomaterialia · 2025Article
- Implementation status of European guidelines on trauma management of prehospital bleeding control: a national survey in Austria.BMC emergency medicine · 2025Article
- Integrated analysis of WGCNA and machine learning identified diagnostic biomarkers in trauma-induced coagulopathy.Scientific reports · 2025Article
- [Visual estimation of blood losses : Known high error rate-How can it be improved?]Die Anaesthesiologie · 2025Article
- Prothrombin time predicting time-dependent and risk-stratified mortality in polytrauma patients.International journal of emergency medicine · 2025Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
introductionWorldwide, trauma is a leading cause of death and disability. Haemorrhage is responsible for up to 40% of trauma deaths. Recent strategies to improve mortality rates have focused on optimal methods of early hemorrhage control and correction of coagulopathy. We undertook a systematic review of randomized controlled trials (RCT) which evaluated trauma patients with hemorrhagic shock within the first 24 hours of injury and appraised how the interventions affected three outcomes: bleeding and/or transfusion requirements; correction of trauma induced coagulopathy and mortality.
methodsComprehensive searches were performed of MEDLINE, EMBASE, CENTRAL (The Cochrane Library Issue 7, 2010), Current Controlled Trials, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP) and the National Health Service Blood and Transplant Systematic Review Initiative (NHSBT SRI) RCT Handsearch Database.
resultsA total of 35 RCTs were identified which evaluated a wide range of clinical interventions in trauma hemorrhage. Many of the included studies were of low methodological quality and participant numbers were small. Bleeding outcomes were reported in 32 studies; 7 reported significantly reduced transfusion use following a variety of clinical interventions, but this was not accompanied by improved survival. Minimal information was found on traumatic coagulopathy across the identified RCTs. Overall survival was improved in only three RCTs: two small studies and a large study evaluating the use of tranexamic acid.
conclusionsDespite 35 RCTs there has been little improvement in outcomes over the last few decades. No clear correlation has been demonstrated between transfusion requirements and mortality. The global trauma community should consider a coordinated and strategic approach to conduct well designed studies with pragmatic endpoints.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.