The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition

Rolf Rossaint*, Arash Afshari, Bertil Bouillon, Vladimir Cerny, Diana Cimpoesu, Nicola Curry, Jacques Duranteau, Daniela Filipescu, Oliver Grottke, Lars Grønlykke, Anatole Harrois, Beverley J. Hunt, Alexander Kaserer, Radko Komadina, Mikkel Herold Madsen, Marc Maegele, Lidia Mora, Louis Riddez, Carolina S. Romero, Charles Marc SamamaJean Louis Vincent, Sebastian Wiberg, Donat R. Spahn

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

155 Citationer (Scopus)
18 Downloads (Pure)

Abstract

Background
Severe trauma represents a major global public health burden and the management of post-traumatic bleeding continues to challenge healthcare systems around the world. Post-traumatic bleeding and associated traumatic coagulopathy remain leading causes of potentially preventable multiorgan failure and death if not diagnosed and managed in an appropriate and timely manner. This sixth edition of the European guideline on the management of major bleeding and coagulopathy following traumatic injury aims to advise clinicians who care for the bleeding trauma patient during the initial diagnostic and therapeutic phases of patient management.

Methods
The pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma included representatives from six European professional societies and convened to assess and update the previous version of this guideline using a structured, evidence-based consensus approach. Structured literature searches covered the period since the last edition of the guideline, but considered evidence cited previously. The format of this edition has been adjusted to reflect the trend towards concise guideline documents that cite only the highest-quality studies and most relevant literature rather than attempting to provide a comprehensive literature review to accompany each recommendation.

Results
This guideline comprises 39 clinical practice recommendations that follow an approximate temporal path for management of the bleeding trauma patient, with recommendations grouped behind key decision points. While approximately one-third of patients who have experienced severe trauma arrive in hospital in a coagulopathic state, a systematic diagnostic and therapeutic approach has been shown to reduce the number of preventable deaths attributable to traumatic injury.

Conclusion
A multidisciplinary approach and adherence to evidence-based guidelines are pillars of best practice in the management of severely injured trauma patients. Further improvement in outcomes will be achieved by optimising and standardising trauma care in line with the available evidence across Europe and beyond.
OriginalsprogEngelsk
Artikelnummer80
TidsskriftCritical Care
Vol/bind27
Udgave nummer1
Antal sider45
ISSN1364-8535
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Costs incurred for medical writing support and publication were supported by unrestricted Grants from CSL Behring GmbH (Marburg, Germany), LFB Biomédicaments (Courtaboeuf, France) and Alexion Pharma Germany GmbH (Munich, Germany). The grantors had no authorship or editorial control over the content of the meetings or any subsequent publication.

Funding Information:
The development of this guideline was initiated and performed by the authors as members of the Task Force for Advanced Bleeding Care in Trauma. Meeting organisation and medical writing support for literature searches and manuscript preparation were provided by Ashfield MedComms GmbH (Mannheim, Germany), an Inizio company. Structured literature searches were designed and performed by Janne Vendt (Copenhagen University Hospital, Herlev, Denmark). This publication has been endorsed by the European Society of Anaesthesiology and Intensive Care (ESAIC), European Society of Intensive Care Medicine (ESICM), European Shock Society (ESS), European Society for Trauma and Emergency Surgery (ESTES), European Society for Emergency Medicine (EuSEM) and the Network for Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA).

Publisher Copyright:
© 2023, The Author(s).

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