Spinella Philip C, Cap Andrew P
aDivision of Critical Care, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri bInstitute of Surgical Research, Joint Base San Antonio, San Antonio, Texas, USA.
Curr Opin Hematol. 2017 Nov;24(6):529-535. doi: 10.1097/MOH.0000000000000386.
To describe how hemostatic resuscitation can be used in the prehospital phase of resuscitation to reduce preventable deaths after traumatic injury.
Hemorrhagic shock is the leading cause of death that is preventable after injury. The National Academy of Sciences, recently, recommended that achievement of zero preventable deaths after traumatic injury should be the goal of a national trauma system. In the United States, there are an estimated 25 000 preventable deaths per year in the prehospital phase of resuscitation because of traumatic hemorrhagic shock. Therefore, to achieve the goal of zero preventable deaths after injury, both shock and hemostatic dysfunction need to be addressed rapidly in the prehospital phase of resuscitation. This review will highlight the epidemiology and outcomes of traumatic hemorrhagic shock, and explore potential solutions such as group O whole blood and platelets stored at 2-6°C. Trauma research receives the lowest funding relative to the burden of morbidity and mortality it creates when compared with all other diseases. Increased resources are required to achieve zero preventable deaths after injury.
Prehospital hemostatic resuscitation has the potential to significantly reduce preventable death from hemorrhage.
描述如何在复苏的院前阶段应用止血复苏以减少创伤性损伤后可预防的死亡。
失血性休克是损伤后可预防的主要死亡原因。美国国家科学院最近建议，创伤性损伤后实现零可预防死亡应成为国家创伤系统的目标。在美国，估计每年在复苏的院前阶段因创伤性失血性休克有25000例可预防死亡。因此，为实现损伤后零可预防死亡的目标，在复苏的院前阶段需要迅速解决休克和止血功能障碍问题。本综述将重点介绍创伤性失血性休克的流行病学和结局，并探索潜在的解决方案，如2-6°C保存的O型全血和血小板。与所有其他疾病相比，创伤研究相对于其造成的发病率和死亡率负担获得的资金最少。需要增加资源以实现损伤后零可预防死亡。
院前止血复苏有可能显著减少因出血导致的可预防死亡。
