Prise en charge transfusionnelle du choc hémorragique d’origine traumatique à la phase aiguë : quoi de neuf en 2009 ?

Morel, Nicolas; Morel, Olivier; Chimot, Loïc; Lortet, V.; Julliac, B.; Lelias, A.; Merson, L.; Dabadie, P.

doi:10.1016/j.annfar.2008.12.023

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…For Boffard et al , the biological objectives were to maintain hematocrit between 20% and 30% (i.e., hemoglobin level of about 8 g/dl and 10 g/dl), PT at 60% and platelet count above 50 000/ml. Our biological objectives[4] encouraged a more aggressive transfusion strategy, with the hemoglobin level maintained at 10 g/dl, PT at 70% and platelet count above 100 000/ml. Recent studies into hemorrhagic shock recommend a more aggressive transfusion procedure, in particular the latest review by Spinella[5] of the RBC/plasma ratio.…”

Section: Discussionmentioning

confidence: 99%

“…This new transfusion strategy is therefore based on clinical data but also on new coagulation theories, as described in our own review of blood transfusion in traumatic hemorrhagic shock. [4] Coagulation is a solid phenomenon that requires the presence of the membranes of cells involved in coagulation (erythrocytes, platelets, leucocytes, and endothelial cells) and coagulation factors. This implies an earlier compensation for the coagulation cells in the hemorrhage processes.…”

Section: Discussionmentioning

confidence: 99%

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Advantage of using a recombinant activated factor VII in traumatic haemorrhagic shock: The Bordeaux experience

Morel

Chabarttier

Merson

et al. 2012

J Emerg Trauma Shock

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Introduction:Several series of patient studies have been published on the use of rFVIIa in traumatic haemorrhagic shock, although to date no international recommendations have been produced. France does not currently recognise traumatic haemorrhagic shock as an appropriate indication for the use of rFVIIa.Materials and methods:In this retrospective study, we present our experience in the use of rFVIIa in traumatic haemorrhagic shock.Results:Twenty-seven patients treated with rFVIIa after a traumatic injury between May 2005 and December 2008 were included. Average age was 46 years old. Eighty per cent of patients were polytransfused. Mortality rate was 33%. Adjusted mortality rate, using the Boffard study criteria, was 8.3%. We observed significant differences between the group of patients who died and the group of survivors in pH, PT, Hb, ionised calcaemia, temperature and platelet count. We observed significant differences between the successful rFVIIa group and the failed rFVIIa group in pH, Hb, platelet count and ionised calcaemia. Ten patients had an rFVIIa injection only and 17 patients had an rFVIIa injection combined with a mechanical procedure to stop the bleeding. Two patients presented with thromboembolic complications. We observed a tendency to recommend an rFVIIa injection before radical treatment is applied.Conclusion:It seems to us legitimate to recommend earlier use of rFVIIa in cases of traumatic haemorrhagic shock in the context of haematological damage control combined with the use of an algorithm to predict the risk involved in polytransfusion and a more aggressive transfusion strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advantage of using a recombinant activated factor VII in traumatic haemorrhagic shock: The Bordeaux experience

Morel

Chabarttier

Merson

et al. 2012

J Emerg Trauma Shock

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show abstract

“…Quatre mé decins anesthé sistes-ré animateurs (MAR) sont pré sents. La prise en charge du blessé hé morragique y est codifié e. Elle suit les recommandations professionnelles françaises et europé ennes [7,8]. Le MAR est le responsable de la ré animation transfusionnelle (RT) et plus particuliè rement de l'utilisation du ST. En effet, la RT en OPEX est encadré e par un texte ré glementaire du SSA [9].…”

Section: Contexteunclassified

“…Au total, 377 CGR provenant de France (acheminé s par le CTSA) ont é té transfusé s ainsi que 167 poches de ST pré levé s sur place. Le taux mé dian d'hé moglobine avant une transfusion é tait de 8,1 g/dL(3,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Soixante-et-onze pour cent des patients (n = 90) ont é té transfusé s dans les 24 heures.…”

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Transfusion sanguine en opération extérieure. Expérience à l’hôpital médico-chirurgical de Kaboul

Esnault¹,

Cungi²,

Romanat³

et al. 2013

Annales Françaises d'Anesthésie et de Réanimation

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Prise en charge transfusionnelle du choc hémorragique d’origine traumatique à la phase aiguë : la stratégie du service de santé des armées

Ausset

Meaudre

Kaiser

et al. 2009

Annales Françaises d'Anesthésie et de Réanimation

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Prise en charge transfusionnelle du choc hémorragique d’origine traumatique à la phase aiguë : quoi de neuf en 2009 ?

Cited by 5 publications

References 38 publications

Advantage of using a recombinant activated factor VII in traumatic haemorrhagic shock: The Bordeaux experience

Advantage of using a recombinant activated factor VII in traumatic haemorrhagic shock: The Bordeaux experience

Transfusion sanguine en opération extérieure. Expérience à l’hôpital médico-chirurgical de Kaboul

Prise en charge transfusionnelle du choc hémorragique d’origine traumatique à la phase aiguë : la stratégie du service de santé des armées

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