Institute of Anaesthesiology, University Hospital Zürich, Zürich, Switzerland.
Acta Anaesthesiol Scand. 2010 Jan;54(1):111-7. doi: 10.1111/j.1399-6576.2009.02132.x. Epub 2009 Oct 26.
Transfusion of allogeneic blood products is associated with increased morbidity and mortality. Therefore, strategies for reducing transfusion of these products during trauma management are valuable. We report a case of severe blunt abdominal trauma, successfully treated with antifibrinolytic medication and fibrinogen concentrate. Rotational thromboelastometry (ROTEM) was used to identify hyperfibrinolysis and afibrinogenaemia. In order to achieve haemostasis, over a 3-h period, the patient received a total of 1 g of tranexamic acid, 7 U of packed red blood cells, 16 g of fibrinogen concentrate (Haemocomplettan P), 3500 ml of colloids and 5500 ml of lactated Ringer's solution. Together with surgical measures, this treatment stopped the bleeding and stabilised the patient. There was no transfusion of either fresh-frozen plasma or platelets. The limited need for allogeneic blood products is of particular interest, and clinical studies of the approach used here appear to be warranted.
输注异体血液制品与发病率和死亡率的增加有关。因此，在创伤管理中减少这些产品的输血策略是有价值的。我们报告了一例严重的钝性腹部创伤病例，成功地使用抗纤维蛋白溶解药物和纤维蛋白原浓缩物进行了治疗。旋转血栓弹性描记术（ROTEM）用于确定纤维蛋白溶解亢进和纤维蛋白原血症。为了止血，在 3 小时内，患者总共接受了 1 克氨甲环酸、7 单位的浓缩红细胞、16 克纤维蛋白原浓缩物（Haemocomplettan P）、3500 毫升胶体和 5500 毫升乳酸林格氏液。结合手术措施，这种治疗方法停止了出血并稳定了患者的病情。没有输注新鲜冷冻血浆或血小板。异体血液制品的需求有限，因此有必要对这里使用的方法进行临床研究。
