Blood Transfusion for Major Trauma in Emergency Department
Severe bleeding is the leading cause of death in patients with major trauma admitted to the emergency department. It is estimated that about 50% of deaths happen within a few minutes of the traumatic event due to massive hemorrhage; 30% of deaths are related to neurological dysfunction and typically...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/7/708 |
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| author | Angela Saviano Cesare Perotti Christian Zanza Yaroslava Longhitano Veronica Ojetti Francesco Franceschi Abdelouahab Bellou Andrea Piccioni Eugenio Jannelli Iride Francesca Ceresa Gabriele Savioli |
| author_facet | Angela Saviano Cesare Perotti Christian Zanza Yaroslava Longhitano Veronica Ojetti Francesco Franceschi Abdelouahab Bellou Andrea Piccioni Eugenio Jannelli Iride Francesca Ceresa Gabriele Savioli |
| author_sort | Angela Saviano |
| collection | DOAJ |
| description | Severe bleeding is the leading cause of death in patients with major trauma admitted to the emergency department. It is estimated that about 50% of deaths happen within a few minutes of the traumatic event due to massive hemorrhage; 30% of deaths are related to neurological dysfunction and typically happen within two days of trauma; and approximately 20% of patients died of multiorgan failure and sepsis within days to weeks of the traumatic event. Over the past ten years, there has been an increased understanding of the underlying mechanisms and pathophysiology associated with traumatic bleeding leading to improved management measures. Traumatic events cause significant tissue damage, with the potential for severe blood loss and the release of cytokines and hormones. They are responsible for systemic inflammation, activation of fibrinolysis pathways, and consumption of coagulation factors. As the final results of this (more complex in real life) cascade, patients can develop tissue hypoxia, acidosis, hypothermia, and severe coagulopathy, resulting in a rapid deterioration of general conditions with a high risk of mortality. Prompt and appropriate management of massive bleeding and coagulopathy in patients with trauma remains a significant challenge for emergency physicians in their daily clinical practice. Our review aims to explore literature studies providing evidence on the treatment of hemorrhage with blood support in patients with trauma admitted to the Emergency Department with a high risk of death. Advances in blood transfusion protocols, along with improvements in other resuscitation strategies, have become one of the most important issues to face and a key topic of recent clinical research in this field. |
| first_indexed | 2024-04-24T10:47:33Z |
| format | Article |
| id | doaj.art-2fb407c832544a6b8acaccab3318d65c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-24T10:47:33Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-2fb407c832544a6b8acaccab3318d65c2024-04-12T13:16:45ZengMDPI AGDiagnostics2075-44182024-03-0114770810.3390/diagnostics14070708Blood Transfusion for Major Trauma in Emergency DepartmentAngela Saviano0Cesare Perotti1Christian Zanza2Yaroslava Longhitano3Veronica Ojetti4Francesco Franceschi5Abdelouahab Bellou6Andrea Piccioni7Eugenio Jannelli8Iride Francesca Ceresa9Gabriele Savioli10Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyDivision of Immunohaematology and Transfusion, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyGeriatric Medicine Residency Program, University of Rome “Tor Vergata”, 00133 Rome, ItalyDepartment of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USAUniversità Cattolica, 00168 Roma, ItalyDepartment of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 8, 00168 Rome, ItalyDepartment of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USAUniversità Cattolica, 00168 Roma, ItalyDepartment of Orthopedics and Traumatology, Fondazione Policlinico San Matteo, 27100 Pavia, ItalyDepartment of Emergency Medicine, Humanitas University, 20089 Milan, ItalyDepartment of Emergency Medicine, Fondazione Policlinico San Matteo, 27100 Pavia, ItalySevere bleeding is the leading cause of death in patients with major trauma admitted to the emergency department. It is estimated that about 50% of deaths happen within a few minutes of the traumatic event due to massive hemorrhage; 30% of deaths are related to neurological dysfunction and typically happen within two days of trauma; and approximately 20% of patients died of multiorgan failure and sepsis within days to weeks of the traumatic event. Over the past ten years, there has been an increased understanding of the underlying mechanisms and pathophysiology associated with traumatic bleeding leading to improved management measures. Traumatic events cause significant tissue damage, with the potential for severe blood loss and the release of cytokines and hormones. They are responsible for systemic inflammation, activation of fibrinolysis pathways, and consumption of coagulation factors. As the final results of this (more complex in real life) cascade, patients can develop tissue hypoxia, acidosis, hypothermia, and severe coagulopathy, resulting in a rapid deterioration of general conditions with a high risk of mortality. Prompt and appropriate management of massive bleeding and coagulopathy in patients with trauma remains a significant challenge for emergency physicians in their daily clinical practice. Our review aims to explore literature studies providing evidence on the treatment of hemorrhage with blood support in patients with trauma admitted to the Emergency Department with a high risk of death. Advances in blood transfusion protocols, along with improvements in other resuscitation strategies, have become one of the most important issues to face and a key topic of recent clinical research in this field.https://www.mdpi.com/2075-4418/14/7/708major traumableedingemergency departmentblood transfusioncoagulation |
| spellingShingle | Angela Saviano Cesare Perotti Christian Zanza Yaroslava Longhitano Veronica Ojetti Francesco Franceschi Abdelouahab Bellou Andrea Piccioni Eugenio Jannelli Iride Francesca Ceresa Gabriele Savioli Blood Transfusion for Major Trauma in Emergency Department Diagnostics major trauma bleeding emergency department blood transfusion coagulation |
| title | Blood Transfusion for Major Trauma in Emergency Department |
| title_full | Blood Transfusion for Major Trauma in Emergency Department |
| title_fullStr | Blood Transfusion for Major Trauma in Emergency Department |
| title_full_unstemmed | Blood Transfusion for Major Trauma in Emergency Department |
| title_short | Blood Transfusion for Major Trauma in Emergency Department |
| title_sort | blood transfusion for major trauma in emergency department |
| topic | major trauma bleeding emergency department blood transfusion coagulation |
| url | https://www.mdpi.com/2075-4418/14/7/708 |
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