Effective approaches to address noncompressible torso hemorrhage.

IF 3.5 3区医学 Q1 CRITICAL CARE MEDICINE

Current Opinion in Critical Care Pub Date : 2024-06-01 Epub Date: 2024-02-28 DOI:10.1097/MCC.0000000000001141

Marc Maegele

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引用次数: 0

Abstract

Purpose of review: Noncompressible torso hemorrhage (NCTH) is now considered as the major cause of preventable death after both severe military and civilian trauma. Around 20% of all trauma patients still die from uncontrolled exsanguination along with rapidly evolving hemostatic failure. This review highlights the most recent advances in the field and provides an outline for future research directions.

Recent findings: The updated definition of NCTH includes a combination of high-grade anatomical torso injury, hemodynamic instability, urgent need for hemorrhage control and aggressive hemostatic resuscitation. Therapeutic concepts consider the following three aspects: control the bleeding source (close the tap), resuscitate to maintain organ perfusion and restore hemostasis (fill the tank), and increase the body's resistance against ischemia (upgrade the armor).

Summary: The concepts for the early management of NCTH have substantially evolved over the last decade. The development of new devices and techniques combined with early intervention of hemostatic failure have contributed to more successful resuscitations. Future research needs to refine and validate their potential clinical application.

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处理非压缩性躯干出血的有效方法。

审查目的：非压缩性躯干出血（NCTH）目前被认为是严重军事和民事创伤后可预防死亡的主要原因。大约 20% 的创伤患者仍然死于无法控制的失血以及迅速发展的止血功能衰竭。本综述重点介绍了该领域的最新进展，并概述了未来的研究方向：新近发现：NCTH 的最新定义包括躯干高级解剖损伤、血液动力学不稳定、急需控制出血和积极止血复苏。治疗理念考虑了以下三个方面：控制出血源（关闭水龙头）、复苏以维持器官灌注和恢复止血（加满油箱）以及增强机体对缺血的抵抗力（升级盔甲）。新设备和新技术的开发以及对止血失败的早期干预为更成功的复苏做出了贡献。未来的研究需要完善和验证其潜在的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Critical Care 医学-危重病医学

CiteScore

5.90

自引率

3.00%

发文量

172

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.