SUMMARY
Patients with MBL resulting in hemorrhagic shock requiring an MT account for a small percentage of total trauma admissions. However, they account for a significant percentage of potentially preventable deaths. DCR techniques, including selective use of permissive hypotension, avoidance of overly aggressive crystalloid resuscitation, and early aggressive transfusion strategies with higher FFP-to-platelets-toPRBC ratios have improved mortality over previous decades. MTPs are useful institutional tools for improving communication between the blood bank and the clinician. MTPs improve availability of blood products, decrease times to transfusion, likely improve mortality, and may decrease cost. Tranexamic acid and prothrombin complex may be beneficial adjuncts to resuscitation of patients in hemorrhagic shock. Viscoelastic testing using TEG/ROTEM is useful in predicting and triggering MTPs and in guiding ongoing resuscitation.
SUMMARYPatients with MBL resulting in hemorrhagic shock requiring an MT account for a small percentage of total trauma admissions. However, they account for a significant percentage of potentially preventable deaths. DCR techniques, including selective use of permissive hypotension, avoidance of overly aggressive crystalloid resuscitation, and early aggressive transfusion strategies with higher FFP-to-platelets-toPRBC ratios have improved mortality over previous decades. MTPs are useful institutional tools for improving communication between the blood bank and the clinician. MTPs improve availability of blood products, decrease times to transfusion, likely improve mortality, and may decrease cost. Tranexamic acid and prothrombin complex may be beneficial adjuncts to resuscitation of patients in hemorrhagic shock. Viscoelastic testing using TEG/ROTEM is useful in predicting and triggering MTPs and in guiding ongoing resuscitation.
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