Guía para Uso de Componentes Sanguíneos

Desarrollo de un Protocolo de Transfusión Masiva

I Instituto de Evaluación Tecnológica en Salud

5.9

Se presenta un modelo de protocolo de transfusión masiva (PTM). En esta sección se analiza la adaptación local del modelo de PTM y el desarrollo de directrices sobre activación y cesación del PTM.

Adaptación local

Un equipo multidisciplinario debe adaptar el modelo de PTM:

Incorporar las recomendaciones y puntos de práctica proporcionados en este módulo
Tener en cuenta los recursos locales (por ejemplo, el acceso a los componentes sanguíneos)
Proporcionar detalles sobre cómo se entregarán los componentes al corregir el paciente y la ubicación
Incluir información de apoyo que explique cómo se comunicará el personal clínico, de laboratorio y de apoyo
Destacar la necesidad de comunicación temprana con un hematólogo o especialista en transfusión.

La plantilla PTM también se puede modificar para poblaciones específicas como los pacientes obstétricos, dado el potencial de hemorragia oculta y el desarrollo temprano de DIC. La instalación local también debe desarrollar materiales para acompañar el PTM, aclarando las funciones y responsabilidades de los miembros del equipo (por ejemplo, tarjetas de tareas).

Activación y cesación

El equipo multidisciplinario también debe desarrollar pautas para la activación y cesación del PTM. Esto ayudará a asegurar que el PTM se utiliza adecuadamente, y el desperdicio de los componentes de la sangre se reduce al mínimo.

La activación del PTM debe tener en cuenta:

La causa y la tasa de la hemorragia
El mecanismo de la lesión (si está presente)
El estado fisiológico actual
El requisito probable de soporte de componentes sanguíneos en curso.

El modelo de PTM presenta sugerencias sobre cuándo activar un PTM. Las directrices sobre la activación y el cese del PTM deben comunicarse claramente a todo el personal. El uso del PTM debe ser auditado.

Referencias

1. Mitra B, Mori A, Cameron PA, Fitzgerald M, Street A and Bailey M. Massive blood transfusion and trauma resuscitation. Injury 2007; 38(9):1023–29. http://www.ncbi.nlm.nih.gov/pubmed/17572415
2. Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, Sebesta J, Jenkins D, Wade CE and Holcomb JB. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. Journal of Trauma 2007; 63(4):805–13. http://www.ncbi.nlm.nih.gov/pubmed/18090009
3. Cosgriff N, Moore EE, Sauaia A, Kenny-Moynihan M, Burch JM and Galloway B. Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited. Journal of Trauma 1997; 42(5):857–61. http://www.ncbi.nlm.nih.gov/pubmed/9191667
4. Ferrara A, MacArthur JD, Wright HK, Modlin IM and McMillen MA. Hypothermia and acidosis worsen coagulopathy in the patient requiring massive transfusion. American Journal of Surgery 1990; 160(5):515–18. http://www.ncbi.nlm.nih.gov/pubmed/2240386
5. Gonzalez EA, Moore FA, Holcomb JB, Miller CC, Kozar RA, Todd SR, Cocanour CS, Balldin BC and McKinley BA. Fresh frozen plasma should be given earlier to patients requiring massive transfusion. Journal of Trauma 2007; 62(1):112–19. http://www.ncbi.nlm.nih.gov/pubmed/17215741
6. Stinger HK, Spinella PC, Perkins JG, Grathwohl KW, Salinas J, Martini WZ, Hess JR, Dubick MA, Simon CD, Beekley AC, Wolf SE, Wade CE and Holcomb JB. The ratio of fibrinogen to red cells transfused affects survival in casualties receiving massive transfusions at an army combat support hospital. Journal of Trauma 2008; 64(2Suppl):S79–85. http://www.ncbi.nlm.nih.gov/pubmed/18376176
7. Vaslef SN, Knudsen NW, Neligan PJ and Sebastian MW. Massive transfusion exceeding 50 units of blood products in trauma patients. Journal of Trauma 2002; 53(2):291–95. http://www.ncbi.nlm.nih.gov/pubmed/12169936
8. Wilson RF, Binkley LE, Sabo FM, Jr., Wilson JA, Munkarah MM, Dulchavsky SA and Diebel LN. Electrolyte and acid-base changes with massive blood transfusions. American Journal of Surgery 1992; 58(9):535–44. http://www.ncbi.nlm.nih.gov/pubmed/1524320
9. Moore FA, Nelson T, McKinley BA, Moore EE, Nathens AB, Rhee P, Puyana JC, Beilman GJ and Cohn SM. Massive transfusion in trauma patients: tissue hemoglobin oxygen saturation predicts poor outcome. Journal of Trauma 2008; 64(4):1010–23. http://www.ncbi.nlm.nih.gov/pubmed/18404069
10. Vivien B, Langeron O, Morell E, Devilliers C, Carli PA, Coriat P and Riou B. Early hypocalcemia in severe trauma. Critical Care Medicine 2005; 33(9):1946–52. http://www.ncbi.nlm.nih.gov/pubmed/16148464
11. Stainsby D, MacLennan S, Thomas D, Isaac J and Hamilton PJ. Guidelines on the management of massive blood loss. British Journal of Haematology 2006; 135(5):634–41. http://www.ncbi.nlm.nih.gov/pubmed/17107347
12. Manno CS, Hedberg KW, Kim HC, Bunin GR, Nicolson S, Jobes D, Schwartz E and Norwood WI (1991). Comparison of the hemostatic effects of fresh whole blood, stored whole blood, and components after open heart surgery in children. Blood 77(5):930–36. http://www.ncbi.nlm.nih.gov/pubmed/1995100
13. Cotton BA, Au BK, Nunez TC, Gunter OL, Robertson AM and Young PP. Predefined massive transfusion protocols are associated with a reduction in organ failure and Post Injury complications. Journal of Trauma 2009; 66(1):41–48. http://www.ncbi.nlm.nih.gov/pubmed/19131804
14. Dente CJ, Shaz BH, Nicholas JM, Harris RS, Wyrzykowski AD, Patel S, Shah A, Vercruysse GA, Feliciano DV, Rozycki GS, Salomone JP and Ingram WL. Improvements in early mortality and coagulopathy are sustained better in patients with blunt trauma after institution of a massive transfusion protocol in a civilian level I trauma center. Journal of Trauma 2009; 66(6):1616–24. http://www.ncbi.nlm.nih.gov/pubmed/19509623
15. Cinat ME, Wallace WC, Nastanski F, West J, Sloan S, Ocariz J and Wilson SE. Improved survival following massive transfusion in patients who have undergone trauma. Archives of Surgery 1999; 134(9):964–68 http://www.ncbi.nlm.nih.gov/pubmed/10487591
16. Gunter OL, Jr., Au BK, Isbell JM, Mowery NT, Young PP and Cotton BA. Optimizing outcomes in damage control resuscitation: identifying blood product ratios associated with improved survival. Journal of Trauma 2008; 65(3):527–534. http://www.ncbi.nlm.nih.gov/pubmed/18784564
17. McLaughlin DF, Niles SE, Salinas J, Perkins JG, Cox ED, Wade CE and Holcomb JB. A predictive model for massive transfusion in combat casualty patients. Journal of Trauma 2008; 64(2Suppl):S57–63. http://www.ncbi.nlm.nih.gov/pubmed/18376173
18. Schreiber MA, Perkins J, Kiraly L, Underwood S, Wade C and Holcomb JB. Early predictors of massive transfusion in combat casualties. Journal of the American College of Surgeons 2007; 205(4):541–545. https://www.ncbi.nlm.nih.gov/pubmed/17903727
19. Spinella PC. Warm fresh whole blood transfusion for severe hemorrhage: U.S. military and potential civilian applications. Critical Care Medicine 2008; 36(7 Suppl): S340–345. http://www.ncbi.nlm.nih.gov/pubmed/18594261
20. Dann EJ, Michaelson M, Barzelay M, Hoffman R and Bonstein L. Transfusion medicine during the summer of 2006: lessons learned in northern Israel. Transfusion Medicine Reviews 2008; 22(1):70–76. http://www.ncbi.nlm.nih.gov/pubmed/18063193
21. Duchesne JC, Hunt JP, Wahl G, Marr AB, Wang YZ, Weintraub SE, Wright MJ and McSwain NE, J. Review of current blood transfusions strategies in a mature level I trauma center: were we wrong for the last 60 years? Journal of Trauma 2008; 65(2):272–276. http://www.ncbi.nlm.nih.gov/pubmed/18695461
22. Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, Gonzalez EA, Pomper GJ, Perkins JG, Spinella PC, Williams KL and Park MS. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Annals of Surgery 2008; 248(3):447–458. http://www.ncbi.nlm.nih.gov/pubmed/18791365
23. Kashuk JL, Moore EE, Johnson JL, Haenel J, Wilson M, Moore JB, Cothren CC, Biffl WL, Banerjee A and Sauaia A. Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer? Journal of Trauma 2008; 65(2):261–270. http://www.ncbi.nlm.nih.gov/pubmed/18695460
24. Maegele M, Lefering R, Paffrath T, Tjardes T, Simanski C and Bouillon B. Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft fur Unfallchirurgie. Vox Sanguinis 2008; 95(2):112–119. http://www.ncbi.nlm.nih.gov/pubmed/18557827
25. Perkins JG, Andrew CP, Spinella PC, Blackbourne LH, Grathwohl KW, Repine TB, et al. An evaluation of the impact of apheresis platelets used in the setting of massively transfused trauma patients. Journal of Trauma 2009; 66(4 Suppl):S77–84. http://www.ncbi.nlm.nih.gov/pubmed/19359974
26. Phillips TF, Soulier G and Wilson RF. Outcome of massive transfusion exceeding two blood volumes in trauma and emergency surgery. Journal of Trauma 1987; 27 (8):903–910. http://www.ncbi.nlm.nih.gov/pubmed/3612868
27. Rose AH, Kotze A, Doolan D, Norfolk DR and Bellamy MC. Massive transfusion–evaluation of current clinical practice and outcome in two large teaching hospital trusts in Northern England. Vox Sanguinis 2009; 97(3):247–253. http://www.ncbi.nlm.nih.gov/pubmed/19497086
28. Scalea TM, Bochicchio KM, Lumpkins K, Hess JR, Dutton R, Pyle A, et al. Early aggressive use of fresh frozen plasma does not improve outcome in critically injured trauma patients. Annals of Surgery 2008; 248(4):578–584. http://www.ncbi.nlm.nih.gov/pubmed/18936570
29. Schwab CW, Civil I and Shayne JP. Saline-expanded group O uncrossmatched packed red blood cells as an initial resuscitation fluid in severe shock. Annals of Emergency Medicine 1986; 15(11):1282–87. http://www.ncbi.nlm.nih.gov/pubmed/3777583
30. Snyder CW, Weinberg JA, McGwin G, Jr., Melton SM, George RL, Reiff DA, et al. The relationship of blood product ratio to mortality: survival benefit or survival bias? Journal of Trauma 2009; 66(2):358–62. http://www.ncbi.nlm.nih.gov/pubmed/19204508
31. Sperry JL, Ochoa JB, Gunn SR, Alarcon LH, Minei JP, Cuschieri J, et al. An FFP: PRBC transfusion ratio >/=1:1.5 is associated with a lower risk of mortality after massive transfusion. Journal of Trauma 2008; 65(5):986–93. http://www.ncbi.nlm.nih.gov/pubmed/19001962
32. Teixeira PG, Inaba K, Shulman I, Salim A, Demetriades D, Brown C, et al. Impact of plasma transfusion in massively transfused trauma patients. Journal of Trauma 2009; 66(3):693–97. http://www.ncbi.nlm.nih.gov/pubmed/19276739
33. Velmahos GC, Chan L, Chan M, Tatevossian R, Cornwell EE, Demetriades D, et al. Is there a limit to massive blood transfusion after severe trauma? Archives of Surgery 1998; 133(9):947–52. http://www.ncbi.nlm.nih.gov/pubmed/9749845
34. Wudel JH, Morris JA, Jr., Yates K, Wilson A and Bass SM. Massive transfusion: outcome in blunt trauma patients. Journal of Trauma 1991; 31(1):1–7. http://www.ncbi.nlm.nih.gov/pubmed/1986111
35. Zink KA, Sambasivan CN, Holcomb JB, Chisholm G and Schreiber MA. A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study. American Journal of Surgery 2009; 197(5):565–70. http://www.ncbi.nlm.nih.gov/pubmed/19393349
36. Spahn DR, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondejar E, Gordini G. Management of bleeding following major trauma: a European guideline. Critical Care 2007;11(1):R17. http://www.ncbi.nlm.nih.gov/pubmed/17298665
37. Chaiwat O, Lang JD, Vavilala MS, Wang J, MacKenzie EJ, Jurkovich GJ and Rivara FP. Early packed red blood cell transfusion and acute respiratory distress syndrome after trauma. Anesthesiology 2009; 110(2):351–60. http://www.ncbi.nlm.nih.gov/pubmed/19164959
38. Silverboard H, Aisiku I, Martin GS, Adams M, Rozycki G and Moss M. The role of acute blood transfusion in the development of acute respiratory distress syndrome in patients with severe trauma. Journal of Trauma 2005; 59(3):717–23. http://www.ncbi.nlm.nih.gov/pubmed/16361918
39. Dutton R, Hauser C, Boffard K, Dimsitts J, Bernard G, Holcomb J, et al. Scientific and logistical challenges in designing the CONTROL trial: recombinant factor VIIa in severe trauma patients with refractory bleeding. Clinical Trials 2009; 6(5):467–79. http://www.ncbi.nlm.nih.gov/pubmed/19737846
40. Boffard KD, Riou B, Warren B, Choong PI, Rizoli S, Rossaint R, et al. Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials. Journal of Trauma 2005; 59(1):8–15. http://www.ncbi.nlm.nih.gov/pubmed/16096533
41. Isbister J, Phillips L, Dunkley S, Jankelowitz G, McNeil J and Cameron P. Recombinant activated factor VII in critical bleeding: experience from the Australian and New Zealand Haemostasis Register. Internal Medicine Journal 2008; 38(3):156–165. http://www.ncbi.nlm.nih.gov/pubmed/17916172
42. Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Meyer W and Scalea TM. Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. World Journal of Surgery 2008; 32(10):2185–89. http://www.ncbi.nlm.nih.gov/pubmed/18575931

Instituto de Evaluación Tecnológica en Salud

IETS Colombia - Instituto de Evaluación Tecnológica en Salud. Instituto de Evaluación Tecnológica en Salud. Fue creado en el 2011 según lo estipulado en la Ley 1438, como una corporación sin ánimo de lucro, con participación de entidades públicas y privadas. De acuerdo con el Departamento Administrativo de la Función Pública, nuestro Instituto es una entidad descentralizada del sector de la salud. Es la Agencia Nacional de Evaluación de Tecnología Sanitaria de Colombia, que genera evidencia con rigor científico para soportar la toma de decisiones, promueve el desarrollo de mejores políticas públicas y prácticas asistenciales en salud con el fin de contribuir al mejoramiento de la salud de los colombianos, y a la sostenibilidad del sistema con legitimidad, innovación, calidad, equidad y eficiencia.

Anterior Siguiente

5.9

Adaptación local

Activación y cesación

Referencias

1. Mitra B, Mori A, Cameron PA, Fitzgerald M, Street A and Bailey M. Massive blood transfusion and trauma resuscitation. Injury 2007; 38(9):1023–29. http://www.ncbi.nlm.nih.gov/pubmed/17572415

3. Cosgriff N, Moore EE, Sauaia A, Kenny-Moynihan M, Burch JM and Galloway B. Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited. Journal of Trauma 1997; 42(5):857–61. http://www.ncbi.nlm.nih.gov/pubmed/9191667

4. Ferrara A, MacArthur JD, Wright HK, Modlin IM and McMillen MA. Hypothermia and acidosis worsen coagulopathy in the patient requiring massive transfusion. American Journal of Surgery 1990; 160(5):515–18. http://www.ncbi.nlm.nih.gov/pubmed/2240386

5. Gonzalez EA, Moore FA, Holcomb JB, Miller CC, Kozar RA, Todd SR, Cocanour CS, Balldin BC and McKinley BA. Fresh frozen plasma should be given earlier to patients requiring massive transfusion. Journal of Trauma 2007; 62(1):112–19. http://www.ncbi.nlm.nih.gov/pubmed/17215741

7. Vaslef SN, Knudsen NW, Neligan PJ and Sebastian MW. Massive transfusion exceeding 50 units of blood products in trauma patients. Journal of Trauma 2002; 53(2):291–95. http://www.ncbi.nlm.nih.gov/pubmed/12169936

8. Wilson RF, Binkley LE, Sabo FM, Jr., Wilson JA, Munkarah MM, Dulchavsky SA and Diebel LN. Electrolyte and acid-base changes with massive blood transfusions. American Journal of Surgery 1992; 58(9):535–44. http://www.ncbi.nlm.nih.gov/pubmed/1524320

9. Moore FA, Nelson T, McKinley BA, Moore EE, Nathens AB, Rhee P, Puyana JC, Beilman GJ and Cohn SM. Massive transfusion in trauma patients: tissue hemoglobin oxygen saturation predicts poor outcome. Journal of Trauma 2008; 64(4):1010–23. http://www.ncbi.nlm.nih.gov/pubmed/18404069

10. Vivien B, Langeron O, Morell E, Devilliers C, Carli PA, Coriat P and Riou B. Early hypocalcemia in severe trauma. Critical Care Medicine 2005; 33(9):1946–52. http://www.ncbi.nlm.nih.gov/pubmed/16148464

11. Stainsby D, MacLennan S, Thomas D, Isaac J and Hamilton PJ. Guidelines on the management of massive blood loss. British Journal of Haematology 2006; 135(5):634–41. http://www.ncbi.nlm.nih.gov/pubmed/17107347

12. Manno CS, Hedberg KW, Kim HC, Bunin GR, Nicolson S, Jobes D, Schwartz E and Norwood WI (1991). Comparison of the hemostatic effects of fresh whole blood, stored whole blood, and components after open heart surgery in children. Blood 77(5):930–36. http://www.ncbi.nlm.nih.gov/pubmed/1995100

13. Cotton BA, Au BK, Nunez TC, Gunter OL, Robertson AM and Young PP. Predefined massive transfusion protocols are associated with a reduction in organ failure and Post Injury complications. Journal of Trauma 2009; 66(1):41–48. http://www.ncbi.nlm.nih.gov/pubmed/19131804

15. Cinat ME, Wallace WC, Nastanski F, West J, Sloan S, Ocariz J and Wilson SE. Improved survival following massive transfusion in patients who have undergone trauma. Archives of Surgery 1999; 134(9):964–68 http://www.ncbi.nlm.nih.gov/pubmed/10487591

16. Gunter OL, Jr., Au BK, Isbell JM, Mowery NT, Young PP and Cotton BA. Optimizing outcomes in damage control resuscitation: identifying blood product ratios associated with improved survival. Journal of Trauma 2008; 65(3):527–534. http://www.ncbi.nlm.nih.gov/pubmed/18784564

17. McLaughlin DF, Niles SE, Salinas J, Perkins JG, Cox ED, Wade CE and Holcomb JB. A predictive model for massive transfusion in combat casualty patients. Journal of Trauma 2008; 64(2Suppl):S57–63. http://www.ncbi.nlm.nih.gov/pubmed/18376173

18. Schreiber MA, Perkins J, Kiraly L, Underwood S, Wade C and Holcomb JB. Early predictors of massive transfusion in combat casualties. Journal of the American College of Surgeons 2007; 205(4):541–545. https://www.ncbi.nlm.nih.gov/pubmed/17903727

19. Spinella PC. Warm fresh whole blood transfusion for severe hemorrhage: U.S. military and potential civilian applications. Critical Care Medicine 2008; 36(7 Suppl): S340–345. http://www.ncbi.nlm.nih.gov/pubmed/18594261

20. Dann EJ, Michaelson M, Barzelay M, Hoffman R and Bonstein L. Transfusion medicine during the summer of 2006: lessons learned in northern Israel. Transfusion Medicine Reviews 2008; 22(1):70–76. http://www.ncbi.nlm.nih.gov/pubmed/18063193

21. Duchesne JC, Hunt JP, Wahl G, Marr AB, Wang YZ, Weintraub SE, Wright MJ and McSwain NE, J. Review of current blood transfusions strategies in a mature level I trauma center: were we wrong for the last 60 years? Journal of Trauma 2008; 65(2):272–276. http://www.ncbi.nlm.nih.gov/pubmed/18695461

25. Perkins JG, Andrew CP, Spinella PC, Blackbourne LH, Grathwohl KW, Repine TB, et al. An evaluation of the impact of apheresis platelets used in the setting of massively transfused trauma patients. Journal of Trauma 2009; 66(4 Suppl):S77–84. http://www.ncbi.nlm.nih.gov/pubmed/19359974

26. Phillips TF, Soulier G and Wilson RF. Outcome of massive transfusion exceeding two blood volumes in trauma and emergency surgery. Journal of Trauma 1987; 27 (8):903–910. http://www.ncbi.nlm.nih.gov/pubmed/3612868

27. Rose AH, Kotze A, Doolan D, Norfolk DR and Bellamy MC. Massive transfusion–evaluation of current clinical practice and outcome in two large teaching hospital trusts in Northern England. Vox Sanguinis 2009; 97(3):247–253. http://www.ncbi.nlm.nih.gov/pubmed/19497086

28. Scalea TM, Bochicchio KM, Lumpkins K, Hess JR, Dutton R, Pyle A, et al. Early aggressive use of fresh frozen plasma does not improve outcome in critically injured trauma patients. Annals of Surgery 2008; 248(4):578–584. http://www.ncbi.nlm.nih.gov/pubmed/18936570

29. Schwab CW, Civil I and Shayne JP. Saline-expanded group O uncrossmatched packed red blood cells as an initial resuscitation fluid in severe shock. Annals of Emergency Medicine 1986; 15(11):1282–87. http://www.ncbi.nlm.nih.gov/pubmed/3777583

30. Snyder CW, Weinberg JA, McGwin G, Jr., Melton SM, George RL, Reiff DA, et al. The relationship of blood product ratio to mortality: survival benefit or survival bias? Journal of Trauma 2009; 66(2):358–62. http://www.ncbi.nlm.nih.gov/pubmed/19204508

31. Sperry JL, Ochoa JB, Gunn SR, Alarcon LH, Minei JP, Cuschieri J, et al. An FFP: PRBC transfusion ratio >/=1:1.5 is associated with a lower risk of mortality after massive transfusion. Journal of Trauma 2008; 65(5):986–93. http://www.ncbi.nlm.nih.gov/pubmed/19001962

32. Teixeira PG, Inaba K, Shulman I, Salim A, Demetriades D, Brown C, et al. Impact of plasma transfusion in massively transfused trauma patients. Journal of Trauma 2009; 66(3):693–97. http://www.ncbi.nlm.nih.gov/pubmed/19276739

33. Velmahos GC, Chan L, Chan M, Tatevossian R, Cornwell EE, Demetriades D, et al. Is there a limit to massive blood transfusion after severe trauma? Archives of Surgery 1998; 133(9):947–52. http://www.ncbi.nlm.nih.gov/pubmed/9749845

34. Wudel JH, Morris JA, Jr., Yates K, Wilson A and Bass SM. Massive transfusion: outcome in blunt trauma patients. Journal of Trauma 1991; 31(1):1–7. http://www.ncbi.nlm.nih.gov/pubmed/1986111

36. Spahn DR, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondejar E, Gordini G. Management of bleeding following major trauma: a European guideline. Critical Care 2007;11(1):R17. http://www.ncbi.nlm.nih.gov/pubmed/17298665

37. Chaiwat O, Lang JD, Vavilala MS, Wang J, MacKenzie EJ, Jurkovich GJ and Rivara FP. Early packed red blood cell transfusion and acute respiratory distress syndrome after trauma. Anesthesiology 2009; 110(2):351–60. http://www.ncbi.nlm.nih.gov/pubmed/19164959

38. Silverboard H, Aisiku I, Martin GS, Adams M, Rozycki G and Moss M. The role of acute blood transfusion in the development of acute respiratory distress syndrome in patients with severe trauma. Journal of Trauma 2005; 59(3):717–23. http://www.ncbi.nlm.nih.gov/pubmed/16361918

41. Isbister J, Phillips L, Dunkley S, Jankelowitz G, McNeil J and Cameron P. Recombinant activated factor VII in critical bleeding: experience from the Australian and New Zealand Haemostasis Register. Internal Medicine Journal 2008; 38(3):156–165. http://www.ncbi.nlm.nih.gov/pubmed/17916172

42. Bochicchio GV, Napolitano L, Joshi M, Bochicchio K, Meyer W and Scalea TM. Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. World Journal of Surgery 2008; 32(10):2185–89. http://www.ncbi.nlm.nih.gov/pubmed/18575931

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