Translation and interpretation of the European guideline on management of major bleeding and coagulopathy following trauma (the fifth edition)_Chinese Journal of Evidence-Based Medicine

Authors：

LU Zongqing ^1,2 , JIA Di ^1,2 ,  YANG Min ^1,2

1. The 2^nd Department of Intensive Care Unit, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;
2. The Laboratory of Cardiopulmonary Resuscitation and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, P.R.China;

Corresponding author：

YANG Min, Email: 512130761@qq.com

Keywords：

Severe trauma; Post-traumatic bleeding; Trauma-induced coagulopathy; Clinical guideline; Management

DOI：

10.7507/1672-2531.201907055

Video：

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Abstract Full text Figures/Tables Video References Cited by

Severe trauma is a challenging medical problem. Uncontrolled post-traumatic hemorrhage and traumatic coagulation dysfunction are closely related to the prognosis of these patients. In May 2019, the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma published the fifth edition of the European guideline on management of major bleeding and coagulopathy following trauma. To assist Chinese in better understanding of the latest developments, this paper translated the main treatment recommendations in the guideline and interpreted the updated content from the fourth edition.

Citation： LU Zongqing, JIA Di, YANG Min. Translation and interpretation of the European guideline on management of major bleeding and coagulopathy following trauma (the fifth edition). Chinese Journal of Evidence-Based Medicine, 2019, 19(10): 1138-1144. doi: 10.7507/1672-2531.201907055 Copy

1.	Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care, 2019, 23(1): 98.
2.	Mutschler M, Nienaber U, Brockamp T, et al. Renaissance of base deficit for the initial assessment of trauma patients: a base deficit-based classification for hypovolemic shock developed on data from 16,305 patients derived from the TraumaRegister DGU®. Crit Care, 2013, 17(2): R42.
3.	Lai WH, Wu SC, Rau CS, et al. Systolic blood pressure lower than heart rate upon arrival at and departure from the emergency department indicates a poor outcome for adult trauma patients. Int J Environ Res Public Health, 2016, 13(6): 528.
4.	Huber-Wagner S, Mand C, Ruchholtz S, et al. Effect of the localisation of the CT scanner during trauma resuscitation on survival: a retrospective, multicentre study. Injury, 2014, 45 (Suppl 3): S76-S82.
5.	Gamal M, Abdelhamid B, Zakaria D, et al. Evaluation of noninvasive hemoglobin monitoring in trauma patients with low hemoglobin levels. Shock, 2018, 49(2): 150-153.
6.	Ryan ML, Maxwell AC, Manning L, et al. Noninvasive hemoglobin measurement in pediatric trauma patients. J Trauma Acute Care Surg, 2016, 81(6): 1162-1166.
7.	Self WH, Semler MW, Wanderer JP, et al. Balanced crystalloids versus saline in noncritically Ill adults. N Engl J Med, 2018, 378(9): 819-828.
8.	Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically Ill adults. N Engl J Med, 2018, 378(9): 829-839.
9.	Bennett BL, Holcomb JB. Battlefield trauma-induced hypothermia: transitioning the preferred method of casualty rewarming. Wilderness Environ Med, 2017, 28(2S): S82-S89.
10.	Allen PB, Salyer SW, Dubick MA, et al. Preventing hypothermia: comparison of current devices used by the US Army in an in vitro warmed fluid model. J Trauma, 2010, 69 (Suppl 1): S154-S161.
11.	Manley JD, Mitchell BJ, DuBose JJ, et al. A modern case series of resuscitative endovascular balloon occlusion of the aorta (REBOA) in an out-of-Hospital, combat casualty care setting. J Spec Oper Med, 2017, 17(1): 1-8.
12.	Gayet-Ageron A, Prieto-Merino D, Ker K, et al. Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40138 bleeding patients. Lancet, 2018, 391(10116): 125-132.
13.	Stein P, Studt JD, Albrecht R, et al. The impact of prehospital tranexamic acid on blood coagulation in trauma patients. Anesth Analg, 2018, 126(2): 522-529.
14.	Gall LS, Vulliamy P, Gillespie S, et al. The S100A10 pathway mediates an occult hyperfibrinolytic subtype in trauma patients. Ann Surg, 2019, 269(6): 1184-1191.
15.	Harr JN, Moore EE, Chin TL, et al. Viscoelastic hemostatic fibrinogen assays detect fibrinolysis early. Eur J Trauma Emerg Surg, 2015, 41(1): 49-56.
16.	Whiting P, Al M, Westwood M, et al. Viscoelastic point-of-care testing to assist with the diagnosis, management and monitoring of haemostasis: a systematic review and cost-effectiveness analysis. Health Technol Assess, 2015, 19(58): 1-228.
17.	Wikkelso A, Wetterslev J, Moller AM, et al. Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding. Cochrane Database Syst Rev, 2016, (8): CD007871.
18.	Gonzalez E, Moore EE, Moore HB, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: apragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg, 2016, 263(6): 1051-1059.
19.	Khan S, Davenport R, Raza I, et al. Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med, 2015, 41(2): 239-247.
20.	Khan S, Brohi K, Chana M, et al. Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. J Trauma Acute Care Surg, 2014, 76(3): 561-568.
21.	Schöchl H, Voelckel W, Maegele M, et al. Endogenous thrombin potential following hemostatic therapy with 4-factor prothrombin complex concentrate: a 7-day observational study of trauma patients. Crit Care, 2014, 18(4): R147.
22.	Gerlach R, Raabe A, Zimmermann M, et al. Factor XIII deficiency and postoperative hemorrhage after neurosurgical procedures. Surg Neurol, 2000, 54(3): 260-264.
23.	Lehmann M, Wallbank AM, Dennis KA, et al. On-chip recalcification of citrated whole blood using a microfluidic herringbone mixer. Biomicrofluidics, 2015, 9(6): 064106.
24.	Frontera JA, Lewin JJ 3rd, Rabinstein AA, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: A statement for healthcare professionals from the neurocritical care society and society of critical care medicine. Neurocrit Care, 2016, 24(1): 6-46.
25.	Singleton T, Kruse-Jarres R, Leissinger C. Emergency department care for patients with hemophilia and von Willebrand disease. J Emerg Med, 2010, 39(2): 158-165.

1. Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care, 2019, 23(1): 98.
2. Mutschler M, Nienaber U, Brockamp T, et al. Renaissance of base deficit for the initial assessment of trauma patients: a base deficit-based classification for hypovolemic shock developed on data from 16,305 patients derived from the TraumaRegister DGU®. Crit Care, 2013, 17(2): R42.
3. Lai WH, Wu SC, Rau CS, et al. Systolic blood pressure lower than heart rate upon arrival at and departure from the emergency department indicates a poor outcome for adult trauma patients. Int J Environ Res Public Health, 2016, 13(6): 528.
4. Huber-Wagner S, Mand C, Ruchholtz S, et al. Effect of the localisation of the CT scanner during trauma resuscitation on survival: a retrospective, multicentre study. Injury, 2014, 45 (Suppl 3): S76-S82.
5. Gamal M, Abdelhamid B, Zakaria D, et al. Evaluation of noninvasive hemoglobin monitoring in trauma patients with low hemoglobin levels. Shock, 2018, 49(2): 150-153.
6. Ryan ML, Maxwell AC, Manning L, et al. Noninvasive hemoglobin measurement in pediatric trauma patients. J Trauma Acute Care Surg, 2016, 81(6): 1162-1166.
7. Self WH, Semler MW, Wanderer JP, et al. Balanced crystalloids versus saline in noncritically Ill adults. N Engl J Med, 2018, 378(9): 819-828.
8. Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically Ill adults. N Engl J Med, 2018, 378(9): 829-839.
9. Bennett BL, Holcomb JB. Battlefield trauma-induced hypothermia: transitioning the preferred method of casualty rewarming. Wilderness Environ Med, 2017, 28(2S): S82-S89.
10. Allen PB, Salyer SW, Dubick MA, et al. Preventing hypothermia: comparison of current devices used by the US Army in an in vitro warmed fluid model. J Trauma, 2010, 69 (Suppl 1): S154-S161.
11. Manley JD, Mitchell BJ, DuBose JJ, et al. A modern case series of resuscitative endovascular balloon occlusion of the aorta (REBOA) in an out-of-Hospital, combat casualty care setting. J Spec Oper Med, 2017, 17(1): 1-8.
12. Gayet-Ageron A, Prieto-Merino D, Ker K, et al. Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40138 bleeding patients. Lancet, 2018, 391(10116): 125-132.
13. Stein P, Studt JD, Albrecht R, et al. The impact of prehospital tranexamic acid on blood coagulation in trauma patients. Anesth Analg, 2018, 126(2): 522-529.
14. Gall LS, Vulliamy P, Gillespie S, et al. The S100A10 pathway mediates an occult hyperfibrinolytic subtype in trauma patients. Ann Surg, 2019, 269(6): 1184-1191.
15. Harr JN, Moore EE, Chin TL, et al. Viscoelastic hemostatic fibrinogen assays detect fibrinolysis early. Eur J Trauma Emerg Surg, 2015, 41(1): 49-56.
16. Whiting P, Al M, Westwood M, et al. Viscoelastic point-of-care testing to assist with the diagnosis, management and monitoring of haemostasis: a systematic review and cost-effectiveness analysis. Health Technol Assess, 2015, 19(58): 1-228.
17. Wikkelso A, Wetterslev J, Moller AM, et al. Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding. Cochrane Database Syst Rev, 2016, (8): CD007871.
18. Gonzalez E, Moore EE, Moore HB, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: apragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg, 2016, 263(6): 1051-1059.
19. Khan S, Davenport R, Raza I, et al. Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med, 2015, 41(2): 239-247.
20. Khan S, Brohi K, Chana M, et al. Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. J Trauma Acute Care Surg, 2014, 76(3): 561-568.
21. Schöchl H, Voelckel W, Maegele M, et al. Endogenous thrombin potential following hemostatic therapy with 4-factor prothrombin complex concentrate: a 7-day observational study of trauma patients. Crit Care, 2014, 18(4): R147.
22. Gerlach R, Raabe A, Zimmermann M, et al. Factor XIII deficiency and postoperative hemorrhage after neurosurgical procedures. Surg Neurol, 2000, 54(3): 260-264.
23. Lehmann M, Wallbank AM, Dennis KA, et al. On-chip recalcification of citrated whole blood using a microfluidic herringbone mixer. Biomicrofluidics, 2015, 9(6): 064106.
24. Frontera JA, Lewin JJ 3rd, Rabinstein AA, et al. Guideline for reversal of antithrombotics in intracranial hemorrhage: A statement for healthcare professionals from the neurocritical care society and society of critical care medicine. Neurocrit Care, 2016, 24(1): 6-46.
25. Singleton T, Kruse-Jarres R, Leissinger C. Emergency department care for patients with hemophilia and von Willebrand disease. J Emerg Med, 2010, 39(2): 158-165.

Chinese Journal of Evidence-Based Medicine

Translation and interpretation of the European guideline on management of major bleeding and coagulopathy following trauma (the fifth edition)

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