Review
Transfusion strategies for major haemorrhage in trauma
Nicola S. Curry,
Ross Davenport,
Corresponding Author
Nicola S. Curry
Oxford Haemophilia & Thrombosis Centre, Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK
NIHR BRC, Blood Theme, Oxford Centre for Haematology, Oxford, UK
Correspondence: Dr Nicola S. Curry, Oxford Haemophilia & Thrombosis Centre, Churchill Hospital, Headley Way, Oxford, OX3 7LE, UK.
E-mail: [email protected]
Search for more papers by this authorRoss Davenport
Centre for Trauma Sciences, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorNicola S. Curry,
Ross Davenport,
Corresponding Author
Nicola S. Curry
Oxford Haemophilia & Thrombosis Centre, Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK
NIHR BRC, Blood Theme, Oxford Centre for Haematology, Oxford, UK
Correspondence: Dr Nicola S. Curry, Oxford Haemophilia & Thrombosis Centre, Churchill Hospital, Headley Way, Oxford, OX3 7LE, UK.
E-mail: [email protected]
Search for more papers by this authorRoss Davenport
Centre for Trauma Sciences, Blizard Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorSummary
Trauma is a leading cause of death worldwide in persons under 44 years of age, and uncontrolled haemorrhage is the most common preventable cause of death in this patient group. The transfusion management of trauma haemorrhage is unrecognisable from 20 years ago. Changes in clinical practice have been driven primarily by an increased understanding of the pathophysiology of trauma-induced coagulopathy (TIC), which is associated with poor clinical outcomes, including a 3- to 4-fold increased risk of death. Targeting this coagulopathy alongside changes to surgical and anaesthetic practices (an overarching strategy known as damage control surgery/damage control resuscitation) has led to a significant reduction in mortality rates over the last two decades. This narrative review will discuss the transfusion practices that are currently used for trauma haemorrhage and the evidence that supports these practices.
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