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Review
. 2022 Oct 26;7(10):710-726.
doi: 10.1530/EOR-22-0054.

Coagulopathy management of multiple injured patients - a comprehensive literature review of the European guideline 2019

Marcel Niemann  1   2 , Ellen Otto  1   2 , Christian Eder  1 , Yasmin Youssef  3 , Lutz Kaufner  4 , Sven Märdian  1
Affiliations
Review

Coagulopathy management of multiple injured patients - a comprehensive literature review of the European guideline 2019

Marcel Niemann et al. EFORT Open Rev. .

Abstract

The European guideline on the management of trauma-induced major bleeding and coagulopathy summarises the most relevant recommendations for trauma coagulopathy management. The management of trauma-induced major bleeding should interdisciplinary follow algorithms which distinguish between life-threatening and non-life-threatening bleeding. Point-of-care viscoelastic methods (VEM) assist target-controlled haemostatic treatment. Neither conventional coagulation assays nor VEM should delay treatment in life-threatening trauma-induced bleeding. Adjustments may be rational due to local circumstances, including the availability of blood products, pharmaceuticals, and employees.

Keywords: coagulation management; coagulopathy; multiple injury.

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Figures

Figure 1
Figure 1
In-house treatment algorithm for managing massive trauma-induced bleeding. 3F-PCC, three-factor prothrombin complex concentrate; APA, antiplatelet agent; aPTT, activated partial thromboplastin time; aXa, anti factor Xa; BE, base excess; Lct, lactate; DOAC, directly acting oral anticoagulants; EC, erythrocyte concentrate; ECA, Ecarin chromogenic assay; FFP, fresh-frozen plasma; FVIII, coagulation factor VIII; FXIII, coagulation factor FXIII; Hb, haemoglobin; Hct, haematocrite; INR, international normalised ratio; PT, prothrobmin time; rFVIIa, recombinant-activated coagulation factor VII; RVV, Russell’s viper venom; TC, thrombocyte concentrate; TXA, tranexamic acid; VEM, viscoelastic method; VKA, vitamin K antagonists.
See this image and copyright information in PMC

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