Contemporary management of major haemorrhage in critical care

Haemorrhagic shock is frequent in critical care settings and responsible for a high mortality rate due to multiple organ dysfunction and coagulopathy. The management of critically ill patients with bleeding and shock is complex, and treatment of these patients must be rapid and definitive. The admin...

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Vydáno v:Intensive care medicine Ročník 50; číslo 3; s. 319 - 331
Hlavní autoři: Maier, Cheryl L., Brohi, Karim, Curry, Nicola, Juffermans, Nicole P., Mora Miquel, Lidia, Neal, Matthew D., Shaz, Beth H., Vlaar, Alexander P. J., Helms, Julie
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2024
Springer
Springer Nature B.V
Témata:
Anesthesiology
Bleeding
Blood Coagulation Disorders - diagnosis
Blood Coagulation Disorders - etiology
Blood Coagulation Disorders - therapy
Blood Component Transfusion
Care and treatment
Critical Care
Critical Care Medicine
Critical Illness - therapy
Emergency medical care
Emergency Medicine
Evidence-based medicine
Health aspects
Hemorrhage
Hemorrhage - etiology
Hemorrhage - therapy
Hemorrhagic shock
Humans
Intensive
Intensive care
Medical colleges
Medicine
Medicine & Public Health
Mortality
Pain Medicine
Pathophysiology
Pediatrics
Pneumology/Respiratory System
Review
Shock
Strategic planning (Business)
Tranexamic acid
United Kingdom
United Kingdom
Massive transfusion
Critical illness
Haemorrhage
Bleeding
Coagulopathy
ISSN:0342-4642, 1432-1238, 1432-1238
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Shrnutí:Haemorrhagic shock is frequent in critical care settings and responsible for a high mortality rate due to multiple organ dysfunction and coagulopathy. The management of critically ill patients with bleeding and shock is complex, and treatment of these patients must be rapid and definitive. The administration of large volumes of blood components leads to major physiological alterations which must be mitigated during and after bleeding. Early recognition of bleeding and coagulopathy, understanding the underlying pathophysiology related to specific disease states, and the development of individualised management protocols are important for optimal outcomes. This review describes the contemporary understanding of the pathophysiology of various types of coagulopathic bleeding; the diagnosis and management of critically ill bleeding patients, including major haemorrhage protocols and post-transfusion management; and finally highlights recent areas of opportunity to better understand optimal management strategies for managing bleeding in the intensive care unit (ICU).
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ISSN:0342-4642
1432-1238
1432-1238
DOI:10.1007/s00134-023-07303-5