SciELO - Scientific Electronic Library Online

vol.36 número7Modelo de probabilidad de ventilación mecánica prolongada índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados




Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google


Medicina Intensiva

versión impresa ISSN 0210-5691


FERNANDEZ-HINOJOSA, E.; MURILLO-CABEZAS, F.; PUPPO-MORENO, A.  y  LEAL-NOVAL, S.R.. Treatment alternatives in massive hemorrhage. Med. Intensiva [online]. 2012, vol.36, n.7, pp.496-503. ISSN 0210-5691.

Massive hemorrhage is the main cause of mortality and morbidity in trauma patients, and is one of the most important causes in any patient following major surgery. Conventional treatment consists of volume replacement, including the transfusion of blood products, so that tissue perfusion and oxygenation may be maintained. Associated hypothermia, acidosis and coagulopathy is a lethal triad. This review focuses on the latest therapeutic management of massive hemorrhage. The authors advocate the use of crystalloids as per protocol (controlled volumes) in order to achieve a systolic blood pressure of 85mmHg. The administration of the three blood products (red cells, plasma, and platelets) should be on a 1:1:1 basis. Where possible, this in turn should be guided by thromboelastography performed at point of care near the patient. Coagulopathy can occur early and late. With the exception of tranexamic acid, the cost-benefit relationships of the hemostatic agents, such as fibrinogen, prothrombin complex, and recombinant F VII, are subject to discussion.

Palabras clave : Transfusion; Prothrombin concentrate complex; Massive hemorrhage; Tranexamic; Fibrinogen; Erythrocytes; Plasma; Platelets; Thromboelastography; Point care.

        · resumen en Español     · texto en Español     · Español ( pdf )


Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons