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Notfall + Rettungsmedizin

Erschienen in:

01.11.2013 | Leitthema

Kontroversen im Gerinnungsmanagement

verfasst von: Dr. D. Dirkmann, M. Burggraf, P. Brendt, B. Hußmann, J. Peters, S. Lendemans

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 7/2013

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Zusammenfassung

Hintergrund

Die Versorgung polytraumatisierter Patienten ist zeitkritisch und stellt das interdisziplinäre Behandlungsteam vor große Herausforderungen. Zumindest 40 % traumaassoziierter Todesfälle werden unkontrollierten Blutungen zugeschrieben, und der hämorrhagische Schock nach Trauma ist die häufigste Ursache für vermeidbare Todesfälle.

Methode

Recherche und Auswertung der Literatur.

Ergebnisse und Schlussfolgerungen

Neben früher chirurgischer Blutstillung und Optimierung der nicht selten vernachlässigten Rahmenbedingungen hat eine frühe Gerinnungs- und Transfusionstherapie ein großes Potenzial, die Letalität des Schwerstverletzten zu reduzieren. Eine schnelle, gezielte Substitution mit Blut- und Gerinnungsprodukten in der Initialphase nach Trauma vermag die unmittelbare Letalität, aber auch mögliche Dauerschäden durch traumaassoziierte Koagulopathie (TIK) suffizient zu konterkarieren. Während der Stellenwert einer frühzeitigen Injektion der antifibrinolytisch wirksamen Tranexamsäure als gesichert gelten darf, werden ein möglicher Nutzen Point-of-Care-durchführbarer, viskoelastischer Gerinnungsassays und die Transfusion von Gerinnungsfaktorkonzentraten weiterhin kontrovers diskutiert.

Vorheriger Artikel Kontroversen in der Traumatologie

Nächster Artikel Katecholamine bei Traumapatienten

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Titel: Kontroversen im Gerinnungsmanagement
verfasst von: Dr. D. Dirkmann
M. Burggraf
P. Brendt
B. Hußmann
J. Peters
S. Lendemans
Publikationsdatum: 01.11.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Notfall + Rettungsmedizin / Ausgabe 7/2013
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI: https://doi.org/10.1007/s10049-013-1713-y

Springerpflege

Zusammenfassung

Hintergrund

Methode

Ergebnisse und Schlussfolgerungen

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