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Volume and Blood Management

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Textbook of Polytrauma Management

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Abstract

Traumatic bleeding is still the main preventable cause of death in severely injured patients. Beside surgical care, trauma resuscitation also aims to detect and treat systemic coagulation disorders as early as possible in order to counteract coagulopathy and stabilize the patient. Initial trauma resuscitation includes restrictive, goal-directed volume resuscitation using crystalloid solutions and vasopressors on demand to maintain the circulation at a low-stable level. A goal-directed factor-based coagulation management was shown to improve outcomes and lower mortality following major trauma and is therefore recommended in first line. This approach requires a predefined coagulation algorithm including repetitive point-of-care measurements as well as a restrictive transfusion management. The increasing use of oral anticoagulants is additionally challenging trauma treatment. Residual effects of anticoagulants should be assessed and quantified quickly with suitable laboratory tests and reversed in case of an ongoing bleeding.

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Authors and Affiliations

  1. Institute of Anesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland

    Alexander Kaserer, Julian Rössler & Donat R. Spahn

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  1. Alexander Kaserer
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  2. Julian Rössler
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  3. Donat R. Spahn
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Correspondence to Donat R. Spahn .

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Editors and Affiliations

  1. Department of Trauma Surgery, University Hospital Zürich, Zürich, Switzerland

    Hans-Christoph Pape

  2. Department of Orthopaedic Surgery & Sports Medicine, The University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Joseph Borrelli Jr.

  3. Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA

    Ernest E. Moore

  4. Klinik für Traumatologie, University Hospital of Zürich, Zürich, Switzerland

    Roman Pfeifer

  5. Rocky Vista University, College of Osteopathic Medicine, Parker, CO, USA

    Philip F. Stahel

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Kaserer, A., Rössler, J., Spahn, D.R. (2022). Volume and Blood Management. In: Pape, HC., Borrelli Jr., J., Moore, E.E., Pfeifer, R., Stahel, P.F. (eds) Textbook of Polytrauma Management . Springer, Cham. https://doi.org/10.1007/978-3-030-95906-7_7

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