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Trauma is a leading cause of death worldwide in persons under 44 years of age, and uncontrolled haemorrhage is the most common preventable cause of death in this patient group. The transfusion management of trauma haemorrhage is unrecognisable from 20 years ago. Changes in clinical practice have been driven primarily by an increased understanding of the pathophysiology of trauma-induced coagulopathy (TIC), which is associated with poor clinical outcomes, including a 3- to 4-fold increased risk of death. Targeting this coagulopathy alongside changes to surgical and anaesthetic practices (an overarching strategy known as damage control surgery/damage control resuscitation) has led to a significant reduction in mortality rates over the last two decades. This narrative review will discuss the transfusion practices that are currently used for trauma haemorrhage and the evidence that supports these practices.

Original publication

DOI

10.1111/bjh.15737

Type

Journal article

Journal

Br J Haematol

Publication Date

02/2019

Volume

184

Pages

508 - 523

Keywords

major bleeding, transfusion, trauma, trauma induced coagulopathy, Blood Coagulation Disorders, Blood Transfusion, Hemorrhage, Humans, Resuscitation, Risk Factors, Wounds and Injuries