Robb W J
Care Management Department, Lehigh Valley Hospital, Allentown, PA 18105, USA.
AACN Clin Issues. 1999 Feb;10(1):69-84; quiz 138-40. doi: 10.1097/00044067-199902000-00007.
The critically injured trauma patient in severe hemorrhagic shock presents a complex and arduous challenge to even the most experienced trauma staff. Lives are at stake as trauma teams feverishly pour massive amounts of blood into severely injured patients attempting to replace entire blood volumes several times over. Prompt identification of patients at risk for hemorrhage and establishment of massive transfusion protocols can provide guidance in managing the transfusion needs of the exsanguinating patient. These state-of-the-art protocols address component therapy, endpoints to transfusion and complications related to massive transfusions. Other treatments, such as autotransfusion and blood substitutes, are promising adjunctive therapies that may in the near future help to improve outcomes in patients who require massive blood transfusions. This article reviews the current standard of care for the trauma patient requiring massive transfusion.
即使对于经验最丰富的创伤救治团队而言，严重失血性休克中的重伤创伤患者也构成了复杂而艰巨的挑战。当创伤团队拼命地向重伤患者大量输血，试图多次补充全血量时，生命危在旦夕。迅速识别有出血风险的患者并制定大量输血方案可为管理正在失血患者的输血需求提供指导。这些先进的方案涉及成分治疗、输血终点以及与大量输血相关的并发症。其他治疗方法，如自体输血和血液替代品，是很有前景的辅助治疗手段，可能在不久的将来有助于改善需要大量输血患者的治疗效果。本文综述了需要大量输血的创伤患者的当前护理标准。
