Gefässchirurgie

, Volume 16, Issue 2, pp 86–92 | Cite as

Lokal und systemisch wirkende Hämostyptika bei Kriegsverwundung

Möglichkeiten der nichtchirurgischen Blutstillung beweglicher Sanitätskräfte
  • D. Hinck
  • S. Finkemeyer
  • M. Dittmer
  • M. Iversen
  • F. Gatzka
  • E. Debus
Leitthema

Zusammenfassung

Die traumatische Blutung ist eine Herausforderung bei der Versorgung von verwundeten Soldaten und verletzten Zivilisten. Das Verbluten ist nach wie vor die häufigste Todesursache bei Kriegsverwundungen und die zweithäufigste bei zivilen Traumapatienten. Die schnelle Blutungskontrolle und die zeitnahe chirurgische Versorgung der Blutung sind die entscheidenden Schritte des Verhütens des Verblutungstodes.

Einerseits ist durch den kampfliniennahen Einsatz von Chirurgen in FOB/FST (Forward Operating Base/Forward Surgical Team) und dem luftgebundenen Verwundetentransport eine frühzeitige chirurgische Versorgung möglich. Anderseits kann der Transport des Soldaten zur FOB/FST oder seine chirurgische Versorgung durch die taktische Lage am Ort der Verwundung oder bei einem Massenfall an Verwundeten verzögert werden.

Dieser Situation Rechnung tragend, sind in den letzten Jahren zahlreiche Produkte zur lokalen und systemischen Blutstillung in den Streitkräften eingeführt worden. Der vorliegende Artikel befasst sich mit den derzeit hauptsächlich im Einsatz befindlichen Hämostyptika, die zur lokalen bzw. systemischen Behandlung von Blutungen zur Verfügung stehen.

Schlüsselwörter

Hämostyptikum Gefäßverletzung Koagulopathie Trauma Blutungskontrolle 

Local and systemically acting hemostatic agents for combat casualties

Options for non-surgical hemorrhage control by Forward Resuscitative Teams

Abstract

Hemorrhaging due to trauma is still a significant challenge when treating wounded soldiers and injured civilians. Exsanguination is the leading preventable cause of mortality in combat casualties and the second leading cause of civilian deaths due to trauma. Immediate control and early surgical intervention of traumatic hemorrhaging are the most effective strategy to prevent exsanguination.

Establishment of far-forward frontline surgical facilities (forward operating base, FOB/forward surgical team, FST) and patient evacuation by air transport guarantee early surgical treatment. However, medical evacuation and surgical treatment can be delayed due to tactical circumstances or in the event of mass casualties.

Therefore a number of local and systemically acting agents have been recently deployed to armed forces which can be used to arrest bleeding before surgical control of the source. The purpose of this article is to summarize these local and systemically acting hemostatic agents currently available for control of traumatic bleeding.

Keywords

Hemostatic agent Vascular injuries Coagulopathy Trauma Bleeding control 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • D. Hinck
    • 1
  • S. Finkemeyer
    • 2
  • M. Dittmer
    • 2
  • M. Iversen
    • 2
  • F. Gatzka
    • 1
  • E. Debus
    • 3
  1. 1.Abteilung für Allgemein-, Thorax- und Viszeralchirurgie, Sektion GefäßchirurgieBundeswehrkrankenhaus HamburgHamburgDeutschland
  2. 2.Abteilung für Anästhesie und RettungsmedizinBundeswehrkrankenhaus HamburgHamburgDeutschland
  3. 3.Klinik und Poliklinik für GefäßmedizinUniversitäres Herzzentrum Universitätsklinikum Hamburg-EppendorfHamburgDeutschland

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