ArticleScandinavian journal of trauma, resuscitation and emergency medicine2015
Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I Trauma Centres.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 63 citations in OpenAlex.
- Multicenter survey on viscoelastic assays access and use in trauma in Swiss emergency departments.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Article
- Integrated analysis of WGCNA and machine learning identified diagnostic biomarkers in trauma-induced coagulopathy.Scientific reports · 2025Article
- Massive transfusion policy in the Netherlands, a nationwide survey.Transfusion · 2025Article
- Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing.Clinical and experimental emergency medicine · 2024Article
- Association of red blood cell distribution width with mortality among multiple trauma patients.Annals of medicine and surgery (2012) · 2024Article
- [Viscoelasticity-based point of care coagulation diagnostics in the context of resuscitation room management of severely injured and bleeding trauma patients : Diagnostics and treatment of trauma-induced coagulopathy].Unfallchirurgie (Heidelberg, Germany) · 2023Review
- Infrastructure, logistics and clinical practice management of acute trauma hemorrhage and coagulopathy: a survey across German trauma centers.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- The European Perspective on the Management of Acute Major Hemorrhage and Coagulopathy after Trauma: Summary of the 2019 Updated European Guideline.Journal of clinical medicine · 2021Article
- The Diagnosis and Treatment of Acute Traumatic Bleeding and Coagulopathy.Deutsches Arzteblatt international · 2019Review
- [Modern coagulation management in bleeding trauma patients : Point-of-care guided administration of coagulation factor concentrates and hemostatic agents].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2019Review
- Towards patient-specific management of trauma hemorrhage: the effect of resuscitation therapy on parameters of thromboelastometry.Journal of thrombosis and haemostasis : JTH · 2019Observational
- Unmatched Type O RhD+ Red Blood Cells in Multiple Injured Patients.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2018Article
- [Viscoelasticity-based treatment of bleeding injuries].Der Unfallchirurg · 2017Review
- Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2017Review
- Damage control in the intensive care unit: what should the intensive care physician know and do?Colombia medica (Cali, Colombia)Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUncontrolled haemorrhage is still the leading cause of preventable death after trauma and the primary focus of any treatment strategy should be related to early detection and control of blood loss including haemostasis.
methodsFor assessing management practices across six European level I trauma centres with academic interest and research in the field of coagulopathy an online survey was conducted addressing local management practice for bleeding trauma patients including algorithms for detection, management and monitoring coagulation disorders and immediate interventions. Each centre provided their locally applied massive transfusion protocol.
resultsAll participating trauma centres have developed and implemented a local algorithm and protocol for the bleeding trauma patient. These are uniformly activated by clinical triggers and deactivated once the bleeding has stopped according to clinical assessment in combination with laboratory signs of achieved haemostasis. The severity of coagulopathy and shock is mostly assessed via standard coagulation tests and partially used extended viscoelastic tests. All centres have implemented the immediate use of tranexamic acid. Initial resuscitation is started either pre-hospital or after hospital admission by using transfusion packages with pre-fixed universal blood product combinations and ratios following the concept of "damage control resuscitation" at which applied ratios substantially vary. Two centres initially start with transfusion packages but with viscoelastic tests running in parallel to quickly allow a shift towards a viscoelastic test-guided therapy.
conclusionDiversity in the management of bleeding trauma patients such as pre-hospital blood administration and routinely performed viscoelastic tests exists even among level I trauma centres. The paucity of consensus among these centres highlights the need for further primary research followed by clinical trials to improve the evidence for sophisticated guidelines and strategies.
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