2013, Number 608
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Rev Med Cos Cen 2013; 70 (608)
Sangrado masivo: Uso de tromboelastometría y tomboelastografía rotacional
Mata CD
Language: Spanish
References: 20
Page: 607-613
PDF size: 272.18 Kb.
ABSTRACT
Massive blood loss is
considered an important
cause of preventable mortality
worldwide. It is associated
with secondary coagulopathy,
a decrease in tissue perfusion,
and consumption of coagulation
factor and platelets. There
are two elemental concepts
that should be distinguished:
control damage surgery and
resuscitation in hemostatic
control; one emphasizes
on provisional but early
hemostatic control, while the
other one seeks prompt control
of coagulopathy. As part of
the therapeutic management
of massive blood loss, the
resuscitation with hemostatic
control peruses an immediate
and sustained plasmatic and
platelet reconstitution, as
well as red blood cells. The
reconstitution of these three
components resembles the
physiologic composition of
blood, impedes hypovolemia
and coagulopathy. Viscoelastic
coagulation tests (such as
ROTEM or TEG) have emerged
as practical, rapid and sensitive
diagnostic modalities. Their role
in therapeutic targeting has
demonstrated multiple benefits.
Blood component transfusion
should be based on the analytic
results of these tests.
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