The clinical effect of hemostatic resuscitation in traumatic hemorrhage; a before-after study

Zwinkels, Rob L.J.; Endeman, Henrik; Hoeks, Sanne E.; Maat, Moniek P.M. de; Hartog, Dennis den; Stolker, Robert Jan

doi:10.1016/j.jcrc.2019.11.013

Cited by 9 publications

(16 citation statements)

References 30 publications

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“…The results of the search and respective levels of screening are outlined in the PRISMA flowchart in Figure 1 [17]. Of those 47 articles, there were only 15, comprising of 2,715 patients, which had published data that could be used to quantitatively assess our primary outcome [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. There was one RCT identified and remaining manuscripts were either retrospective or prospective observational studies of moderate methodological quality.…”

Section: Resultsmentioning

confidence: 99%

Detection of Acute Traumatic Coagulopathy by Viscoelastic Haemostatic Assays Compared to Standard Laboratory Tests: A Systematic Review

Forster

Hendel

Mitra

2022

Transfus Med Hemother

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Introduction: The aim of this systematic review was to investigate whether viscoelastic haemostatic assays (VHAs) offer comparative diagnostic ability of acute traumatic coagulopathy (ATC) compared to the standard laboratory coagulation tests (SLCT). ATC is a complication of major trauma characterized by dysfunctional blood clotting, leading to an increased bleeding risk. Additionally, we aimed to analyse the association of VHA with blood product use and health outcomes. Methods: The search protocol was pre-published and completed on December 2, 2020, assessing manuscripts from 2000 until the present. We searched MEDLINE, Embase, Cochrane Central, BIOSIS, Emcare, CINAHL, and additional online resources and referenced lists. Included were manuscripts that quantitatively reported the detection of ATC using VHAs and SLCTs. A meta-analysis was undertaken including observational studies that reported on patients with injuries to all body regions and results analysed using a random-effects model and reported using pooled odds ratio with 95% confidence intervals (CI). Results: There were 14 observational studies and one randomized control trial involving 2,715 participants that satisfied inclusion criteria. We observed significant heterogeneity in the definitions of ATC, study design, setting, and patient population. Among observational studies that reported on patients with injuries to all body regions, VHAs were associated with higher odds of diagnosing ATC compared to SLCT (pooled OR 2.4; 95% CI: 1.4–4.1). There was inadequate evidence to suggest VHAs were associated with reduced blood product usage or lower mortality. Conclusion: VHAs detected more patients with ATC compared to SLCTs. However, the clinical significance and applicability of this finding remains unknown as translation to management was not adequately reported.

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Section: Resultsmentioning

confidence: 99%

Detection of Acute Traumatic Coagulopathy by Viscoelastic Haemostatic Assays Compared to Standard Laboratory Tests: A Systematic Review

Forster

Hendel

Mitra

2022

Transfus Med Hemother

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“…Já numa coorte que avaliou 405 pacientes com sangramento agudo, no grupo tratado com CCP e PFC, os pacientes que receberam doses mais altas de CCP (≥20 UI/kg) tiveram a maior utilização de hemoderivados, os autores apontaram para o possível risco de viés de seleção, uma vez que estes pacientes possuíam sangramento mais grave, e nesse mesmo estudo as plaquetas foram as mais comumente administradas após o paciente ter recebido CCP/PFC, seguido do concentrado de hemácias (Chowdary et al, 2018). Zwinkels et al (2020), mostraram redução na transfusão de concentrado de PFC e aumento do uso de concentrados de plaquetas e de fibrinogênio ao comparar pacientes que corrigiram a coagulopatia traumática através de um protocolo de ressuscitação hemostática, que incluía administração de hemoderivados e concentrados de fatores da coagulação (CF e CCP),…”

Section: Efeitos Na Redução Do Uso De Hemoderivadosunclassified

O papel do concentrado de complexo protrombrínico no manejo da coagulopatia induzida por trauma: uma revisão integrativa

Santos

Silva²,

Moura³

et al. 2023

RSD

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Introdução: O trauma é uma doença que vitimiza quase 6 milhões de pessoas todos os anos. O sangramento decorrente do trauma desencadeia uma coagulopatia complexa, que necessita de tratamento imediato para melhorar a sobrevida do paciente. O tratamento é baseado em remover a fonte de sangramento, utilizar hemoderivados e concentrados de fatores da coagulação, associado com hipotensão permissiva e reposição controlada de fluídos cristaloides. Objetivo: Avaliar os efeitos da utilização dos concentrados de complexo de protrombina no manejo da coagulopatia induzida por trauma no departamento de emergência. Metodologia: este estudo trata-se de uma revisão integrativa da literatura. O mecanismo de busca utilizado dentro das bases de dados foi: (Bleeding OR Hemorrhage OR Hemostasis OR “Blood Coagulation Disorders") AND (“Prothrombin Complex Concentrates”). Foram incluídos artigos de 2017 a 2022, textos completos disponíveis, em inglês, português e espanhol. Foram excluídos cartas, editoriais e relatos de caso, não correspondentes à temática e os duplicados. Resultados: Após a aplicação dos critérios de inclusão e exclusão, 37 artigos foram selecionados para leitura na íntegra, resultando numa amostra final de 15 artigos para compor esta revisão integrativa, sendo nove artigos da MEDLINE, cinco da SCOPUS e um da SCIENCEDirect. Conclusão: O concentrado de complexo de protrombina é um importante adjuvante no manejo da coagulopatia induzida por trauma, devido à capacidade para reduzir a razão normalizada internacional e a mortalidade sem aumentar o risco de eventos tromboembólicos.

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“…Excessive blood loss in trauma or surgery is one of the most common factors threatening human life and health, and the uncontrollable bleeding is also a primary cause of traumatic death [1,2]. Therefore, an efficient and suitable hemostatic agent is urgently needed to provide more options and opportunities for prehospital emergency hemostasis.…”

Section: Introductionmentioning

confidence: 99%

The hemostatic performance and mechanism of palygorskite with structural regulate by oxalic acid gradient leaching

Yang,

Wang,

et al. 2024

Biomed. Mater.

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Palygorskite (Pal) is a naturally available one-dimensional clay mineral, featuring rod-shaped morphology, nanoporous structure, permanent negative charges as well as abundant surface hydroxyl groups, exhibiting promising potential as a natural hemostatic material. In this study, the hemostatic performance and mechanisms of Pal were systematically investigated based on the structural regulate induced by oxalic acid (OA) gradient leaching from perspectives of structure, surface attributes and ion release. In vitro and in vivo hemostasis evaluation showed that Pal with OA leaching for 1 h exhibited a superior blood procoagulant effect compared with the raw Pal as well as the others leached for prolonging time. This phenomenon might be ascribed to the synergistic effect of the intact nanorod-like morphology, the increase in the surface negative charge, the release of metal ions (Fe3+ and Mg2+), and the improved blood affinity, which promoted the intrinsic coagulation pathway, the fibrinogenesis and the adhesion of blood cells, thereby accelerating the formation of robust blood clots. This work is expected to provide experimental and theoretical basis for the construction of hemostatic biomaterials based on clay minerals.

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The clinical effect of hemostatic resuscitation in traumatic hemorrhage; a before-after study

Cited by 9 publications

References 30 publications

Detection of Acute Traumatic Coagulopathy by Viscoelastic Haemostatic Assays Compared to Standard Laboratory Tests: A Systematic Review

Detection of Acute Traumatic Coagulopathy by Viscoelastic Haemostatic Assays Compared to Standard Laboratory Tests: A Systematic Review

O papel do concentrado de complexo protrombrínico no manejo da coagulopatia induzida por trauma: uma revisão integrativa

The hemostatic performance and mechanism of palygorskite with structural regulate by oxalic acid gradient leaching

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