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Med Intensiva. 2015 Nov;39(8):483-504. doi: 10.1016/j.medin.2015.05.002. Epub 2015 Jul 29.

Multidisciplinary consensus document on the management of massive haemorrhage (HEMOMAS document).

[Article in English, Spanish]

Author information

1
Anestesia y Reanimación, Hospital Clínico Universitario de Valencia, Valencia, España.
2
Anestesia y Reanimación, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
3
Hemoterapia y Hematología, Hospital Clínic i Provincial de Barcelona, Barcelona, España.
4
Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Virgen de las Nieves; Instituto de Investigación Biosanitaria ibs.Granada, Granada, España. Electronic address: enrique.fernandez.mondejar.sspa@juntadeandalucia.es.
5
Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, España.
6
Hemoterapia y Hematología, Hospital General de Alicante, Alicante, España.
7
Anestesia y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
8
Hematología y Hemoterapia, Clínica Universidad de Navarra, Pamplona, España.
9
Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
10
Unidad de Cuidados Intensivos, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.

Abstract

Massive haemorrhage is common and often associated with high morbidity and mortality. We perform a systematic review of the literature, with extraction of the recommendations from the existing evidences because of the need for its improvement and the management standardization. From the results we found, we wrote a multidisciplinary consensus document. We begin with the agreement in the definitions of massive haemorrhage and massive transfusion, and we do structured recommendations on their general management (clinical assessment of bleeding, hypothermia management, fluid therapy, hypotensive resuscitation and damage control surgery), blood volume monitoring, blood products transfusion (red blood cells, fresh frozen plasma, platelets and their best transfusion ratio), and administration of hemostatic components (prothrombin complex, fibrinogen, factor VIIa, antifibrinolytic agents).

KEYWORDS:

Blood component transfusion; Blood transfusion; Choque hemorrágico; Conferencia de consenso; Consenso; Consensus; Consensus development conference; Hemorragia; Hemorrhage; Plasma; Shock, Hemorrhagic; Transfusión de componentes sanguíneos; Transfusión sanguínea

PMID:
26233588
DOI:
10.1016/j.medin.2015.05.002
[Indexed for MEDLINE]
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