3. trauma
causa principale di morte nel
mondo
in persone di età inferiore ai 40 anni
responsabile di oltre il 50% di tutti i
decessi legati al trauma
circa il 10% di tutti i decessi
emorragia massiva
nelle prime 48 ore
dopo ricovero ospedaliero
cardiochirurgia
chirurgia epatobiliare
peripartum
5. attivazione di proteina C
effetto anticoagulante
disattivando irreversibilmente
fattore Va e VIIa
disattivazione di PAI1 enzima
att-inib del plasminogeno
creando iperfibrinolisi
23. Trasfusioni massive e
risparmio del sangue quali strategie
appropriatezza
ricerca della maggior efficacia
outcome
il paziente che può tornare a casa
Editor's Notes
Ossimoro :
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
A fronte di questo è chiaro che a fronte i questo oltre ad ottenere una rapida diagnosi e ad un altrettanto rapido trattamento chirurgico si rende necessaria una precoce
valutazione delle condizioni coagulative per intraprendere un’adeguato trattamento farmacologico e trasfusionale
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
Figure 1 Flowchart of initial management of traumatic hemorrhagic shock. In the acute phase of traumatic hemorrhagic shock, the therapeutic priority is to stop the bleeding. As long as this bleeding is not controlled, the physician must manage fluid resuscitation, vasopressors, and blood transfusion to prevent or treat acute coagulopathy of trauma. AP, arterial pressure; SAP, systolic arterial pressure; TBI, trauma brain injury; Hb, hemoglobin; PT, prothrombin time; APTT, activated partial thromboplastin time.
