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Minerva Anestesiologica 2021 Oct 12

DOI: 10.23736/S0375-9393.21.15914-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Massive Transfusion in trauma: an evolving paradigm

Tobias GAUSS 1, Jean-Denis MOYER 1, Pierre BOUZAT 2

1 Anesthesia and Critical Care, Hôpital Beaujon, DMU PARABOL, APHP Nord, Université de Paris, Paris, France; 2 Université Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France


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A considerable amount of literature has nurtured the idea that massive transfusion is an independent trauma disease and therapeutic tool. In this opinion paper, the authors expose the evolution and challenge the classic paradigm and historic definition of massive transfusion. Based on current evidence the elements of an evolving strategy in transfusion management and bleeding control are exposed such as use of tranexamic acid, combination and ratios of blood products, use of fluids and viscoelastic testing. The synergy of these elements provides the basis to develop updated strategies and perspectives for transfusion management after trauma and to consider a classic definition of massive transfusion as outdated or the need for massive transfusion as failure. An alternative concept, Time Critical Transfusion may be better placed to take into account modern transfusion management after trauma.


KEY WORDS: Massive transfusion; Severe Trauma; Blood products

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