TAILIEUCHUNG - Báo cáo y học: "Hemostatic resuscitation for acute traumatic coagulopathy Thomas M Scalea"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Hemostatic resuscitation for acute traumatic coagulopathy Thomas M Scalea | Scalea Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 2 http content 19 1 2 S SCANDINAVIAN JOURNAL OF Et emergency medicine COMMENTARY Open Access Hemostatic resuscitation for acute traumatic coagulopathy Thomas M Scalea Abstract Trauma resuscitation paradigms have changed considerably over the last twenty years. Originally the goal was to normalize a blood pressure as quickly as possible. Large volume crystalloid resuscitation was used to accomplish this. Standard therapy was that any patient with suspected bleeding received a two liter crystalloid bolus as initial therapy. It was often repeated and blood transfusion therapy was used relatively late. Fresh frozen plasma and platelets were also used relatively late often after patients had received ten units of red cells. Dilutional anemia was relatively common. Patients with large volume blood loss often died from what was termed the bloody vicious cycle of hypothermia acidosis and coagulopathy. Commentary Trauma resuscitation paradigms have changed considerably over the last twenty years. Originally the goal was to normalize a blood pressure as quickly as possible. Large volume crystalloid resuscitation was used to accomplish this. Standard therapy was that any patient with suspected bleeding received a two liter crystalloid bolus as initial therapy. It was often repeated and blood transfusion therapy was used relatively late. Fresh frozen plasma and platelets were also used relatively late often after patients had received ten units of red cells. Dilu-tional anemia was relatively common. Patients with large volume blood loss often died from what was termed the bloody vicious cycle of hypothermia acidosis and coagulopathy. Some of this was almost certainly iatrogenic from our resuscitation strategies 1 . The epidemic of urban violence that plagued large American cities in the late 1980 s and early 1990 s focused trauma surgeons on rethinking how we cared for serious .

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