Department of Anaesthesiology and Intensive Care, AUVA Trauma Centre, Salzburg, Austria.
Anaesthesia. 2015 Jan;70 Suppl 1:102-7, e35-7. doi: 10.1111/anae.12901.
Trauma-induced coagulopathy represents a life-threatening complication in severely injured patients. To avoid exsanguination, rapid surgical bleeding control coupled with immediate and aggressive haemostatic treatment is mandatory. In most trauma centres, coagulation therapy is established with transfusion of high volumes of fresh frozen plasma. Due to logistic issues, only busy trauma facilities store pre-thawed plasma ready for immediate transfusion. Thus, substantial time delays have been reported between the first unit of red blood cells transfused and the administration of fresh frozen plasma. An alternative for rapid improvement of haemostatic capacity is purified coagulation factor concentrates. They contain a well-defined concentration of coagulation proteins, carry a low risk for transfusion-related lung injury and virus transmission, and are available for immediate use without the need for blood group matching. In some European trauma centres, treatment algorithms have been developed for the administration of coagulation factor concentrates based on visco-elastic test results.
创伤性凝血病是严重创伤患者的一种危及生命的并发症。为了避免出血，必须快速进行外科止血，并立即进行积极的止血治疗。在大多数创伤中心，通过输注大量新鲜冷冻血浆来建立凝血治疗。由于后勤问题，只有繁忙的创伤机构才会预先解冻血浆以备立即输注。因此，在输注第一批红细胞与输注新鲜冷冻血浆之间，报告了大量的时间延迟。一种快速提高止血能力的替代方法是纯化的凝血因子浓缩物。它们含有明确浓度的凝血蛋白，输血相关肺损伤和病毒传播的风险低，并且可立即使用，无需进行血型匹配。在一些欧洲创伤中心，根据黏弹性测试结果，制定了凝血因子浓缩物给药的治疗算法。
