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dc.contributor.authorWinearls, James
dc.contributor.authorMitra, Biswadev
dc.contributor.authorC. Reade, Michael
dc.date.accessioned2017-08-10T01:17:33Z
dc.date.available2017-08-10T01:17:33Z
dc.date.issued2017
dc.identifier.issn0952-7907
dc.identifier.doi10.1097/ACO.0000000000000447
dc.identifier.urihttp://hdl.handle.net/10072/343699
dc.description.abstractPurpose of review: Recent advances in the understanding of the pathophysiological processes associated with traumatic haemorrhage and trauma-induced coagulopathy have resulted in improved outcomes for seriously injured trauma patients. However, a significant number of trauma patients still die from haemorrhage. This article reviews the various transfusion strategies utilized in the management of traumatic haemorrhage and describes the major haemorrhage protocol (MHP) strategy employed by an Australian trauma centre. Recent findings: Few topics in trauma resuscitation incite as much debate and controversy as to what constitutes the ‘ideal’ MHP. There is a widespread geographical and institutional variation in clinical practice. Three strategies are commonly utilized; fixed ratio major haemorrhage protocol (FRMHP), viscoelastic haemostatic assay (VHA)-guided MHP and hybrid MHP. The majority of trauma centres utilize an FRMHP and there is high-level evidence to support the use of high blood product ratios. It can be argued that the FRMHP is too simplistic to be applied to all trauma patients and that the use of VHA-guided MHP with predominant factor concentrate transfusion can allow rapid individualized interventions. In between these two strategies is a hybrid MHP, combining early FRMHP with subsequent VHA-guided transfusion. Summary: There are advantages and disadvantages to each of the various MHP strategies and the evidence base to support one above another with any certainty is lacking at this time. One strategy cannot be considered superior to the other and the choice of MHP is dependent on interpretation of the current literature and local institutional logistical considerations. A number of exciting studies are currently underway that will certainly increase the evidence base and help inform clinical practice.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofpagefrom265
dc.relation.ispartofpageto276
dc.relation.ispartofissue2
dc.relation.ispartofjournalCurrent Opinion in Anaesthesiology
dc.relation.ispartofvolume30
dc.subject.fieldofresearchPublic Health and Health Services not elsewhere classified
dc.subject.fieldofresearchCardiorespiratory Medicine and Haematology
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode111799
dc.subject.fieldofresearchcode1102
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1117
dc.titleHaemotherapy algorithm for the management of trauma-induced coagulopathy: An Australian perspective
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.facultyGriffith Health, School of Medical Science
gro.hasfulltextNo Full Text
gro.griffith.authorWinearls, James


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