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Llau JV, Aldecoa C, Guasch E, Marco P, Marcos-Neira P, Paniagua P, Páramo JA, Quintana M, Rodríguez-Martorell FJ, Serrano A. Multidisciplinary consensus document on the management of massive haemorrhage. First update 2023 (document HEMOMAS-II). REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2023; 70:409-421. [PMID: 37640281 DOI: 10.1016/j.redare.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 08/31/2023]
Abstract
This document is an update of the multidisciplinary document HEMOMAS, published in 2016 with the endorsement of the Spanish Scientific Societies of Anaesthesiology (SEDAR), Intensive Care (SEMICYUC) and Thrombosis and Haemostasis (SETH). The aim of this document was to review and update existing recommendations on the management of massive haemorrhage. The methodology of the update was based on several elements of the ADAPTE method by searching and adapting guidelines published in the specific field of massive bleeding since 2014, plus a literature search performed in PubMed and EMBASE from January 2014 to June 2021. Based on the review of 9 guidelines and 207 selected articles, the 47 recommendations in the original article were reviewed, maintaining, deleting, or modifying each of them and the accompanying grades of recommendation and evidence. Following a consensus process, the final wording of the article and the resulting 41 recommendations were approved by all authors.
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Affiliation(s)
- Juan V Llau
- Anestesiología y Reanimación, Hospital Universitario Doctor Peset, València, Spain.
| | - César Aldecoa
- Anestesiología y Reanimación, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Emilia Guasch
- Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, Spain
| | - Pascual Marco
- Hemoterapia y Hematología, Hospital General Universitario Dr. Balmis, Alicante, Spain
| | - Pilar Marcos-Neira
- Medicina Intensiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Pilar Paniagua
- Anestesiología y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José A Páramo
- Hematología y Hemoterapia, Clínica Universidad de Navarra, Pamplona, Spain
| | - Manuel Quintana
- Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain
| | | | - Ainhoa Serrano
- Medicina Intensiva, Hospital Clínico Universitario, València, Spain
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Llau JV, Aldecoa C, Guasch E, Marco P, Marcos-Neira P, Paniagua P, Páramo JA, Quintana M, Rodríguez-Martorell FJ, Serrano A. Multidisciplinary consensus document on the management of massive haemorrhage. First update 2023 (document HEMOMAS-II). Med Intensiva 2023; 47:454-467. [PMID: 37536911 DOI: 10.1016/j.medine.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/26/2023] [Indexed: 08/05/2023]
Abstract
This document is an update of the multidisciplinary document HEMOMAS, published in 2016 with the endorsement of the Spanish Scientific Societies of Anaesthesiology (SEDAR), Intensive Care (SEMICYUC) and Thrombosis and Haemostasis (SETH). The aim of this document was to review and update existing recommendations on the management of massive haemorrhage. The methodology of the update was based on several elements of the ADAPTE method by searching and adapting guidelines published in the specific field of massive bleeding since 2014, plus a literature search performed in PubMed and EMBASE from January 2014 to June 2021. Based on the review of 9 guidelines and 207 selected articles, the 47 recommendations in the original article were reviewed, maintaining, deleting, or modifying each of them and the accompanying grades of recommendation and evidence. Following a consensus process, the final wording of the article and the resulting 41 recommendations were approved by all authors.
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Affiliation(s)
- Juan V Llau
- Anestesiología y Reanimación, Hospital Universitario Doctor Peset, Valencia, Spain.
| | - César Aldecoa
- Anestesiología y Reanimación, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Emilia Guasch
- Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, Spain
| | - Pascual Marco
- Hemoterapia y Hematología, Hospital General Universitario Dr. Balmis, Alicante, Spain
| | | | - Pilar Paniagua
- Anestesiología y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José A Páramo
- Hematología y Hemoterapia, Clínica Universidad de Navarra, Pamplona, Spain
| | - Manuel Quintana
- Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain
| | | | - Ainhoa Serrano
- Medicina Intensiva, Hospital Clínico Universitario, Valencia, Spain
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Pomper GJ, Pham HP, Maracaja DLV, Fadeyi EA. Emergency Release Transfusion Practices Provide an Enduring Reminder of Festina Lente-to Make Haste Slowly. Am J Clin Pathol 2022; 158:445-446. [PMID: 36066411 DOI: 10.1093/ajcp/aqac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Gregory J Pomper
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Huy P Pham
- National Marrow Donor Program, Seattle Apheresis Collection Center, Seattle, WA, USA
| | - Danielle L V Maracaja
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Emmanuel A Fadeyi
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Boye M, Py N, Libert N, Chrisment A, Pissot M, Dedome E, Martinaud C, Ausset S, Boutonnet M, De Rudnicki S, Pasquier P, Martinez T. Step by step transfusion timeline and its challenges in trauma: A retrospective study in a level one trauma center. Transfusion 2022; 62 Suppl 1:S30-S42. [PMID: 35781713 DOI: 10.1111/trf.16953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hemorrhagic shock is the leading cause of preventable early death in trauma patients. Transfusion management is guided by international guidelines promoting early and aggressive transfusion strategies. This study aimed to describe transfusion timelines in a trauma center and to identify key points to performing early and efficient transfusions. METHODS This is a monocentric retrospective study of 108 severe trauma patients, transfused within the first 48 h and hospitalized in an intensive care unit between January 2017 and May 2019. RESULTS One hundred and eight patients were transfused with 1250 labile blood products. Half of these labile blood products were transfused within 3 h of admission and consumed by 26 patients requiring massive transfusion (≥4 red blood cells [RBC] within 1 h). Among these, the median delay from patient's admission to labile blood products prescription was -11 min (-34 to -1); from admission to delivery of labile blood products was 1 min (-20 to 16); and from admission to first transfusion was 20 min (7-37) for RBC, 26 min (13-38) for plasma, and 72 min (51-103) for platelet concentrates. The anticipated prescription of labile blood products and the use of massive transfusion packs and lyophilized plasma units were associated with earlier achievement of high transfusion ratios. CONCLUSION This study provides detailed data on the transfusion timelines and composition, from prescription to initial transfusion. Transfusion anticipation, use of preconditioned transfusion packs including platelets, and lyophilized plasma allow rapid and high-ratio transfusion practices in severe trauma patients.
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Affiliation(s)
- Matthieu Boye
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France.,École du Val-de-Grâce, French Military Medical Service Academy, Paris, France
| | - Nicolas Py
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France.,École du Val-de-Grâce, French Military Medical Service Academy, Paris, France
| | - Nicolas Libert
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France
| | - Anne Chrisment
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France
| | - Mathieu Pissot
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France
| | | | - Christophe Martinaud
- École du Val-de-Grâce, French Military Medical Service Academy, Paris, France.,FMBI, French Military Blood Institute, Clamart, France
| | - Sylvain Ausset
- École du Val-de-Grâce, French Military Medical Service Academy, Paris, France.,FMHSS, French Military Health Service Schools, Lyon, France
| | - Mathieu Boutonnet
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France.,École du Val-de-Grâce, French Military Medical Service Academy, Paris, France
| | - Stéphane De Rudnicki
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France
| | - Pierre Pasquier
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France.,École du Val-de-Grâce, French Military Medical Service Academy, Paris, France.,1ère Chefferie du Service de Santé, French Military Medical Service, Villacoublay, France
| | - Thibault Martinez
- Federation of anesthesiology, intensive care unit, burns and operating theater, Percy Military Training Hospital, Clamart, France
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