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Erschienen in: Wiener klinisches Magazin 4/2019

26.08.2019 | Traumatologie

Moderne Gerinnungstherapie beim blutenden Schwerverletzten

Faktorengabe nach „Point-of-care“

verfasst von: Prof. Dr. med. Marc Maegele

Erschienen in: Wiener klinisches Magazin | Ausgabe 4/2019

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Zusammenfassung

Unkontrollierte Blutungen einschließlich traumaindizierter Koagulopathie (TIK) sind nach wie vor die häufigste vermeidbare Todesursache beim Schwerverletzten, und rasche Diagnostik und Behandlung sind mit verbessertem Outcome assoziiert. Eine an Zielwerten orientierte individualisierte Therapie („goal-directed therapy“) unter Einschluss von „Point-of-care“-Verfahren ist möglicherweise der empirischen und verhältnisbasierten Therapie mit Blutprodukten vorzuziehen. Bei der vorliegenden Arbeit handelt es sich um eine selektive Literaturübersicht unter Berücksichtigung aktueller Empfehlungen/Expertenmeinungen zur Gerinnungstherapie bei blutenden Schwerverletzten über individualisierte Therapie („goal-directed therapy“) mit „Point-of-care“ viskoelastischer Substitution (ROTEM®) von Gerinnungsfaktoren und gerinnungsstabilisierenden Substanzen. Die Gabe von Fibrinogenkonzentrat beim blutenden Schwerverletzten ist ab ROTEM®-FIBTEM A10 < 10 mm (FIBTEM A5 < 9 mm; FIBTEM MCF <12 mm) und erniedrigter EXTEM A10 < 45 mm (EXTEM A5 < 35 mm; EXTEM MCF <55 mm) zu erwägen; die Gabe von Prothrombinkomplexkonzentrat (PPSB) basierend auf einer verzögerten Gerinnselinitiierung (ROTEM®-EXTEM CT >80 s). Aussagen zum Monitoring eines FXIII-Defizits oder zur Therapiesteuerung mit FXIII-Konzentraten sind derzeit nicht möglich. Viskoelastische Testverfahren zeichnen sich durch hohe Sensitivität und Spezifität für den Nachweis einer Hyperfibrinolyse mit therapeutischer Konsequenz der Gabe eines Antifibrinolytikums aus. Individualisierte Therapiekonzepte auf Grundlage von „Point-of-care“ viskoelastischen Testverfahren (ROTEM®) bieten eine sinnvolle Alternative zu den verhältnisbasierten Konzepten und sind mit reduziertem Transfusionsbedarf und reduzierter Morbidität vergesellschaftet.
Literatur
1.
Zurück zum Zitat Brohi K, Singh J, Heron M, Coats T (2003) Acute traumatic coagulopathy. J Trauma 54(6):1127–1130 CrossRefPubMed Brohi K, Singh J, Heron M, Coats T (2003) Acute traumatic coagulopathy. J Trauma 54(6):1127–1130 CrossRefPubMed
2.
Zurück zum Zitat Brohi K, Cohen MJ, Ganter MT et al (2008) Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 64(5):1211–1217 CrossRefPubMed Brohi K, Cohen MJ, Ganter MT et al (2008) Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 64(5):1211–1217 CrossRefPubMed
4.
Zurück zum Zitat Camazine MN, Hemmila MR, Leonard JC et al (2015) Massive transfusion policies at trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program. J Trauma Acute Care Surg 78(6 Suppl 1):48–53 CrossRef Camazine MN, Hemmila MR, Leonard JC et al (2015) Massive transfusion policies at trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program. J Trauma Acute Care Surg 78(6 Suppl 1):48–53 CrossRef
6.
Zurück zum Zitat Da Luz LT, Nascimento B, Shankarakutty AK et al (2014) Effect of thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review. Crit Care 18(5):518 CrossRefPubMedPubMedCentral Da Luz LT, Nascimento B, Shankarakutty AK et al (2014) Effect of thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review. Crit Care 18(5):518 CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Davenport R, Manson J, De’Ath H et al (2011) Functional definition and characterization of acute traumatic coagulopathy. Crit Care Med 39(12):2652–2658 CrossRefPubMedPubMedCentral Davenport R, Manson J, De’Ath H et al (2011) Functional definition and characterization of acute traumatic coagulopathy. Crit Care Med 39(12):2652–2658 CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Dirkmann D, Görlinger K, Peters J (2014) Assessment of early thromboelastometric variables from extrinsically activated assays with and without aprotinin for rapid detection of fibrinolysis. Anesth Analg 119(3):533–542 CrossRefPubMed Dirkmann D, Görlinger K, Peters J (2014) Assessment of early thromboelastometric variables from extrinsically activated assays with and without aprotinin for rapid detection of fibrinolysis. Anesth Analg 119(3):533–542 CrossRefPubMed
9.
Zurück zum Zitat Dirks J, Jorgensen H, Jensen CH et al (2010) Blood product ratio in acute traumatic coagulopathy: effect on mortality in a Scandinavian level I trauma centre. Scand J Trauma Resusc Emerg Med 18:65 CrossRefPubMedPubMedCentral Dirks J, Jorgensen H, Jensen CH et al (2010) Blood product ratio in acute traumatic coagulopathy: effect on mortality in a Scandinavian level I trauma centre. Scand J Trauma Resusc Emerg Med 18:65 CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Etchill E, Sperry J, Zuckerbraun B et al (2016) The confusion continues: Results from an American Association for the Surgery in Trauma survey on massive transfusion practices among United States trauma centers. Transfusion 56(10):2478–2486 CrossRefPubMed Etchill E, Sperry J, Zuckerbraun B et al (2016) The confusion continues: Results from an American Association for the Surgery in Trauma survey on massive transfusion practices among United States trauma centers. Transfusion 56(10):2478–2486 CrossRefPubMed
11.
Zurück zum Zitat Floccard B, Rugeri L, Faure A et al (2012) Early coagulopathy in trauma patients: an on-scene and hospital admission study. Injury 43(1):26–32 CrossRefPubMed Floccard B, Rugeri L, Faure A et al (2012) Early coagulopathy in trauma patients: an on-scene and hospital admission study. Injury 43(1):26–32 CrossRefPubMed
12.
Zurück zum Zitat Gerlach R, Raabe A, Zimmermann M et al (2000) Factor XIII deficiency and postoperative hemorrhage after neurosurgical procedures. Surg Neurol 54:260–264 CrossRefPubMed Gerlach R, Raabe A, Zimmermann M et al (2000) Factor XIII deficiency and postoperative hemorrhage after neurosurgical procedures. Surg Neurol 54:260–264 CrossRefPubMed
13.
Zurück zum Zitat Gonzales E, Moore EE, Moore HB et al (2016) Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg 263(6):1051–1059 CrossRef Gonzales E, Moore EE, Moore HB et al (2016) Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg 263(6):1051–1059 CrossRef
14.
Zurück zum Zitat Görlinger K, Fries D, Dirkmann D et al (2012) Reduction of fresh frozen plasma requirements by perioperative point-of-care coagulation management with early calculated goal-directed therape. Transfus Med Hemother 39:104–113 CrossRefPubMedPubMedCentral Görlinger K, Fries D, Dirkmann D et al (2012) Reduction of fresh frozen plasma requirements by perioperative point-of-care coagulation management with early calculated goal-directed therape. Transfus Med Hemother 39:104–113 CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Gratz J, Güting H, Thorn S et al (2019) Protocolized thromboelasdtometric-guided haemostatic management in patients with traumatic brain injury: a pilot study. Anaesthesia 74(7):883–890 CrossRefPubMed Gratz J, Güting H, Thorn S et al (2019) Protocolized thromboelasdtometric-guided haemostatic management in patients with traumatic brain injury: a pilot study. Anaesthesia 74(7):883–890 CrossRefPubMed
16.
Zurück zum Zitat Grossmann E, Akyol D, Eder L et al (2013) Thromboelastometric detection of clotting factor XIII deficiency in cardiac surgery patients. Transfus Med 23(6):407–415 CrossRefPubMed Grossmann E, Akyol D, Eder L et al (2013) Thromboelastometric detection of clotting factor XIII deficiency in cardiac surgery patients. Transfus Med 23(6):407–415 CrossRefPubMed
17.
Zurück zum Zitat Gruen RL, Jurkovich GJ, McIntyre LK et al (2006) Patterns of errors contributing to trauma mortality: lessons learned from 2,594 deaths. Ann Surg 244(3):371–380 PubMedPubMedCentral Gruen RL, Jurkovich GJ, McIntyre LK et al (2006) Patterns of errors contributing to trauma mortality: lessons learned from 2,594 deaths. Ann Surg 244(3):371–380 PubMedPubMedCentral
18.
Zurück zum Zitat Haas T, Spielmann N, Mauch J et al (2012) Reproducibility of thrombelastometry (ROTEM®): point-of-care versus hospital laboratory performance. Scand J Clin Lab Invest 72(4):313–317 CrossRefPubMed Haas T, Spielmann N, Mauch J et al (2012) Reproducibility of thrombelastometry (ROTEM®): point-of-care versus hospital laboratory performance. Scand J Clin Lab Invest 72(4):313–317 CrossRefPubMed
19.
Zurück zum Zitat Hagemo JS, Stanworth S, Juffermans NP et al (2014) Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study. Crit Care 18(2):R52 CrossRefPubMedPubMedCentral Hagemo JS, Stanworth S, Juffermans NP et al (2014) Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study. Crit Care 18(2):R52 CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Harr JN, Moore EE, Ghasabyan A et al (2013) Functional fibrinogen assay indicates that fibrinogen is critical in correcting abnormal clot strength following trauma. Shock 39(1):45–49 PubMedPubMedCentral Harr JN, Moore EE, Ghasabyan A et al (2013) Functional fibrinogen assay indicates that fibrinogen is critical in correcting abnormal clot strength following trauma. Shock 39(1):45–49 PubMedPubMedCentral
21.
Zurück zum Zitat Hayakawa M, Gando S, Ono Y et al (2015) Fibrinogen level deteriorates before other routine coagulation parameters and massive transfusion in the early phase of severe trauma: a retrospective observational study. Semin Thromb Hemost 41(1):35–42 CrossRefPubMed Hayakawa M, Gando S, Ono Y et al (2015) Fibrinogen level deteriorates before other routine coagulation parameters and massive transfusion in the early phase of severe trauma: a retrospective observational study. Semin Thromb Hemost 41(1):35–42 CrossRefPubMed
22.
Zurück zum Zitat Hiippala ST, Myllylä GJ, Vahtera EM (1995) Hemostatic factors and replacement of major blood loss with plasma-poor red cell concentrates. Anesth Analg 81(2):360–365 PubMed Hiippala ST, Myllylä GJ, Vahtera EM (1995) Hemostatic factors and replacement of major blood loss with plasma-poor red cell concentrates. Anesth Analg 81(2):360–365 PubMed
23.
Zurück zum Zitat Inaba K, Karamanos E, Lustenberger T et al (2013) Impact of fibrinogen levels on outcomes after acute injury in patients requiring a massive transfusion. J Am Coll Surg 216(2):290–297 CrossRefPubMed Inaba K, Karamanos E, Lustenberger T et al (2013) Impact of fibrinogen levels on outcomes after acute injury in patients requiring a massive transfusion. J Am Coll Surg 216(2):290–297 CrossRefPubMed
24.
Zurück zum Zitat Inaba K, Rizoli S, Veigas PV et al (2015) Consensus conference on viscoelastic test-based transfusion guidelines for early trauma resuscitation: report of the panel. J Trauma Acute Care Surg 78(6):1220–1229 CrossRefPubMed Inaba K, Rizoli S, Veigas PV et al (2015) Consensus conference on viscoelastic test-based transfusion guidelines for early trauma resuscitation: report of the panel. J Trauma Acute Care Surg 78(6):1220–1229 CrossRefPubMed
25.
Zurück zum Zitat Innerhofer P, Fries D, Mittermayer M et al (2017) reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates of fresh frozen plasma (RETIC): a single-centre, parallel-group, open-label, randomized trial. Lancet Haematol 4(6):e258–e271 CrossRefPubMed Innerhofer P, Fries D, Mittermayer M et al (2017) reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates of fresh frozen plasma (RETIC): a single-centre, parallel-group, open-label, randomized trial. Lancet Haematol 4(6):e258–e271 CrossRefPubMed
26.
Zurück zum Zitat Johansson P, Stensballe J, Olivieri R et al (2014) How I treat patients with massive hemorrhage. Blood 124:3052–3058 CrossRefPubMed Johansson P, Stensballe J, Olivieri R et al (2014) How I treat patients with massive hemorrhage. Blood 124:3052–3058 CrossRefPubMed
27.
Zurück zum Zitat Juffermans N, Wirtz M, Balvers K et al (2019) Towards patient-specific management of trauma hemorrhage: The effect of resuscitation therapy on parameters of thromboelastometry. J Thromb Haemost 17(3):441–448 CrossRefPubMedPubMedCentral Juffermans N, Wirtz M, Balvers K et al (2019) Towards patient-specific management of trauma hemorrhage: The effect of resuscitation therapy on parameters of thromboelastometry. J Thromb Haemost 17(3):441–448 CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Kashuk JL, Moore EE, Sawyer M et al (2010) Primary fibrinolysis is integral in the pathogenesis of the acute coagulopathy of trauma. Ann Surg 252(3):434 PubMed Kashuk JL, Moore EE, Sawyer M et al (2010) Primary fibrinolysis is integral in the pathogenesis of the acute coagulopathy of trauma. Ann Surg 252(3):434 PubMed
29.
Zurück zum Zitat Khan S, Brohi K, Chana M et al (2014) Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. J Trauma Acute Care Surg 76(3):561–567 CrossRefPubMed Khan S, Brohi K, Chana M et al (2014) Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. J Trauma Acute Care Surg 76(3):561–567 CrossRefPubMed
30.
Zurück zum Zitat Khan S, Davenport R, Raza I et al (2014) Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med 41(2):239–247 CrossRefPubMed Khan S, Davenport R, Raza I et al (2014) Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med 41(2):239–247 CrossRefPubMed
31.
Zurück zum Zitat Kutcher ME, Redick BJ, McCreery RC et al (2012) Characterization of platelet dysfunction after trauma. J Trauma Acute Care Surg 73(1):13–19 CrossRefPubMedPubMedCentral Kutcher ME, Redick BJ, McCreery RC et al (2012) Characterization of platelet dysfunction after trauma. J Trauma Acute Care Surg 73(1):13–19 CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Lang T, von Depka M (2009) Diagnostische Möglichkeiten und Grenzen der Thrombelastometrie/-graphie. Hamostaseologie 26(Suppl 1):20–29 Lang T, von Depka M (2009) Diagnostische Möglichkeiten und Grenzen der Thrombelastometrie/-graphie. Hamostaseologie 26(Suppl 1):20–29
33.
Zurück zum Zitat Levrat A, Gros A, Rugeri L et al (2008) Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients. Br J Anaesth 100(6):792–797 CrossRefPubMed Levrat A, Gros A, Rugeri L et al (2008) Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients. Br J Anaesth 100(6):792–797 CrossRefPubMed
34.
Zurück zum Zitat Lorand L, Losowsky MS, Miloszeewski KJ (1980) Human factor XIII: fibrin-stabalizing factor. Prog Hemost Thromb 5:245–290 PubMed Lorand L, Losowsky MS, Miloszeewski KJ (1980) Human factor XIII: fibrin-stabalizing factor. Prog Hemost Thromb 5:245–290 PubMed
35.
Zurück zum Zitat MacLeod JB, Lynn M, McKenney MG et al (2003) Early coagulopathy predicts mortality in trauma. J Trauma 55(1):39–44 CrossRefPubMed MacLeod JB, Lynn M, McKenney MG et al (2003) Early coagulopathy predicts mortality in trauma. J Trauma 55(1):39–44 CrossRefPubMed
36.
Zurück zum Zitat Maegele M, Lefering R, Yucel N et al (2007) Early coagulopathy in multiple injury: an analysis from the German trauma registry on 8724 patients. Injury 38(3):298–304 CrossRefPubMed Maegele M, Lefering R, Yucel N et al (2007) Early coagulopathy in multiple injury: an analysis from the German trauma registry on 8724 patients. Injury 38(3):298–304 CrossRefPubMed
37.
Zurück zum Zitat Maegele M, Schöchl H, Cohen MJ (2014) An update on the coagulopathy of trauma. Shock 41(Suppl 1):21–25 CrossRefPubMed Maegele M, Schöchl H, Cohen MJ (2014) An update on the coagulopathy of trauma. Shock 41(Suppl 1):21–25 CrossRefPubMed
38.
Zurück zum Zitat Maegele M, Inaba K, Rizoli S et al (2015) Early viscoelasticity-based coagulation therapy for severely injured bleeding patients : report of the consensus group on the consensus conference 2014 for formulation of S2k guidelines. Anaesthesist 64(10):778–794 CrossRefPubMed Maegele M, Inaba K, Rizoli S et al (2015) Early viscoelasticity-based coagulation therapy for severely injured bleeding patients : report of the consensus group on the consensus conference 2014 for formulation of S2k guidelines. Anaesthesist 64(10):778–794 CrossRefPubMed
39.
Zurück zum Zitat Mann KG, Butenas S, Brummel K (2003) The dynamics of thrombin formation. Arterioscler Thromb Vasc Biol 23:17–25 CrossRefPubMed Mann KG, Butenas S, Brummel K (2003) The dynamics of thrombin formation. Arterioscler Thromb Vasc Biol 23:17–25 CrossRefPubMed
40.
Zurück zum Zitat Moore HB, Moore EE, Gonzalez E et al (2014) Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: the spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy. J Trauma Acute Care Surg 77(6):811–817 CrossRefPubMedPubMedCentral Moore HB, Moore EE, Gonzalez E et al (2014) Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: the spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy. J Trauma Acute Care Surg 77(6):811–817 CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Moore EE, Moore HB, Gonzalez E et al (2016) Rationale for the selective administration of tranexamic acid to inhibit fibrinolysis in the severely injured patient. Transfusion 56:110–114 CrossRef Moore EE, Moore HB, Gonzalez E et al (2016) Rationale for the selective administration of tranexamic acid to inhibit fibrinolysis in the severely injured patient. Transfusion 56:110–114 CrossRef
42.
Zurück zum Zitat Nienaber U, Innerhofer P, Westermann I et al (2011) The impact of fresh frozen plasma vs coagulation factor concentrates on morbidity and mortality in trauma-associated haemorrhage and massive transfusion. Injury 42(7):697–701 CrossRefPubMed Nienaber U, Innerhofer P, Westermann I et al (2011) The impact of fresh frozen plasma vs coagulation factor concentrates on morbidity and mortality in trauma-associated haemorrhage and massive transfusion. Injury 42(7):697–701 CrossRefPubMed
43.
Zurück zum Zitat Raza I, Davenport R, Rourke C et al (2013) The incidence and magnitude of fibrinolytic activation in trauma patients. J Thromb Haemost 11(2):307–314 CrossRefPubMed Raza I, Davenport R, Rourke C et al (2013) The incidence and magnitude of fibrinolytic activation in trauma patients. J Thromb Haemost 11(2):307–314 CrossRefPubMed
44.
Zurück zum Zitat Rourke C, Curry N, Khan S et al (2012) Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes. J Thromb Haemost 10(7):1342–1351 CrossRefPubMed Rourke C, Curry N, Khan S et al (2012) Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes. J Thromb Haemost 10(7):1342–1351 CrossRefPubMed
45.
Zurück zum Zitat Rugeri L, Levrat A, David JS et al (2007) Diagnosis of early coagulation abnormalities in trauma patients by rotation thrombelastography. J Thromb Haemost 5(2):289–295 CrossRefPubMed Rugeri L, Levrat A, David JS et al (2007) Diagnosis of early coagulation abnormalities in trauma patients by rotation thrombelastography. J Thromb Haemost 5(2):289–295 CrossRefPubMed
47.
Zurück zum Zitat Schäfer N, Driessen A, Fröhlich M et al (2015) Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I trauma centres. Scand J Trauma Resusc Emerg Med 23:74 CrossRefPubMedPubMedCentral Schäfer N, Driessen A, Fröhlich M et al (2015) Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I trauma centres. Scand J Trauma Resusc Emerg Med 23:74 CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Schöchl H, Frietsch T, Pavelka M et al (2009) Hyperfibrinolysis after major trauma: differential diagnosis of lysis patterns and prognostic value of thrombelastometry. J Trauma 67(1):125–131 CrossRefPubMed Schöchl H, Frietsch T, Pavelka M et al (2009) Hyperfibrinolysis after major trauma: differential diagnosis of lysis patterns and prognostic value of thrombelastometry. J Trauma 67(1):125–131 CrossRefPubMed
49.
Zurück zum Zitat Schöchl H, Forster L, Woidke R et al (2010) Use of rotation thromboelastometry (ROTEM®) to achieve successful treatment of polytrauma with fibrinogen concentrate and prothrombin complex concentrate. Anaesthesia 65(2):199–203 CrossRefPubMed Schöchl H, Forster L, Woidke R et al (2010) Use of rotation thromboelastometry (ROTEM®) to achieve successful treatment of polytrauma with fibrinogen concentrate and prothrombin complex concentrate. Anaesthesia 65(2):199–203 CrossRefPubMed
50.
Zurück zum Zitat Schöchl H, Nienaber U, Maegele M et al (2011) Transfusion in trauma: Thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care 15(2):R83 CrossRefPubMedPubMedCentral Schöchl H, Nienaber U, Maegele M et al (2011) Transfusion in trauma: Thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care 15(2):R83 CrossRefPubMedPubMedCentral
51.
Zurück zum Zitat Schöchl H, Schlimp C, Voelkel W (2012) Goal-directed coagulation management in trauma-related bleeding. Shock 38(4):32–43 Schöchl H, Schlimp C, Voelkel W (2012) Goal-directed coagulation management in trauma-related bleeding. Shock 38(4):32–43
52.
Zurück zum Zitat Schöchl H, Maegele M, Solomon C et al (2012) Early and individualized goal-directed therapy for trauma-induced coagulopathy. Scand J Trauma Resusc Emerg Med 20:15 CrossRefPubMedPubMedCentral Schöchl H, Maegele M, Solomon C et al (2012) Early and individualized goal-directed therapy for trauma-induced coagulopathy. Scand J Trauma Resusc Emerg Med 20:15 CrossRefPubMedPubMedCentral
53.
Zurück zum Zitat Schöchl H, Maegele M, Voelckel W (2016) Fixed ratio versus goal-directed therapy in trauma. Curr Opin Anaesthesiol 29(2):234–244 CrossRefPubMed Schöchl H, Maegele M, Voelckel W (2016) Fixed ratio versus goal-directed therapy in trauma. Curr Opin Anaesthesiol 29(2):234–244 CrossRefPubMed
55.
Zurück zum Zitat Solomon C, Traintinger S, Ziegler B et al (2011) Platelet function following trauma: a multiple electrode aggregometry study. Thromb Haemost 106(2):322–330 PubMed Solomon C, Traintinger S, Ziegler B et al (2011) Platelet function following trauma: a multiple electrode aggregometry study. Thromb Haemost 106(2):322–330 PubMed
56.
Zurück zum Zitat Spahn D, Bouillon B, Cerny V et al (2019) The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care 23(1):98 CrossRefPubMedPubMedCentral Spahn D, Bouillon B, Cerny V et al (2019) The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care 23(1):98 CrossRefPubMedPubMedCentral
57.
Zurück zum Zitat Stensballe J, Ostrowski SR, Johansson PI (2014) Viscoelastic guidance of resuscitation. Curr Opin Anaesthesiol 27(2):212–218 CrossRefPubMed Stensballe J, Ostrowski SR, Johansson PI (2014) Viscoelastic guidance of resuscitation. Curr Opin Anaesthesiol 27(2):212–218 CrossRefPubMed
58.
Zurück zum Zitat Tapia NM, Chang A, Norman M et al (2013) TEG-guided resuscitation is superior to standardized MTP resuscitation in massively transfused penetrating trauma patients. J Trauma Acute Care Surg 74(2):378–385 CrossRefPubMed Tapia NM, Chang A, Norman M et al (2013) TEG-guided resuscitation is superior to standardized MTP resuscitation in massively transfused penetrating trauma patients. J Trauma Acute Care Surg 74(2):378–385 CrossRefPubMed
59.
Zurück zum Zitat Teixeira PG, Inaba K, Hadjizacharia P et al (2007) Preventable or potentially preventable mortality at a mature trauma center. J Trauma 63(6):1228–1346 CrossRef Teixeira PG, Inaba K, Hadjizacharia P et al (2007) Preventable or potentially preventable mortality at a mature trauma center. J Trauma 63(6):1228–1346 CrossRef
60.
Zurück zum Zitat Theusinger OM, Baulig W, Asmis LM et al (2010) In vitro factor XIII supplementation increases clot firmness in rotation thromboelastometry (ROTEM). Thromb Haemost 104:385–391 CrossRefPubMed Theusinger OM, Baulig W, Asmis LM et al (2010) In vitro factor XIII supplementation increases clot firmness in rotation thromboelastometry (ROTEM). Thromb Haemost 104:385–391 CrossRefPubMed
61.
Zurück zum Zitat Theusinger OM, Stein P, Levy JH (2015) Point-of-care and factor concentrate-based coagulation algorithms. Transfus Med Hemother 42(2):115–121 CrossRefPubMedPubMedCentral Theusinger OM, Stein P, Levy JH (2015) Point-of-care and factor concentrate-based coagulation algorithms. Transfus Med Hemother 42(2):115–121 CrossRefPubMedPubMedCentral
62.
Zurück zum Zitat Vrettou CS, Stravrinou LH, Halikias S et al (2010) Factor XIII deficiency as a potential as a potential cause of supratentorial haemorrhage after posterior fossa surgery. Acta Neurochir (Wien) 152:529–532 CrossRef Vrettou CS, Stravrinou LH, Halikias S et al (2010) Factor XIII deficiency as a potential as a potential cause of supratentorial haemorrhage after posterior fossa surgery. Acta Neurochir (Wien) 152:529–532 CrossRef
63.
Zurück zum Zitat Weber CF, Jambor C, Marquardt M et al (2008) Thrombelastometric detection of factor XIII deficiency. Anaesthesist 57(5):487–490 CrossRefPubMed Weber CF, Jambor C, Marquardt M et al (2008) Thrombelastometric detection of factor XIII deficiency. Anaesthesist 57(5):487–490 CrossRefPubMed
64.
Zurück zum Zitat Weber C, Sanders JO, Friedrich K et al (2011) Stellenwert der Thromelastometrie für das Monitoring von Faktor XIII. Prospektive Observationsstudie bei neurochirurgischen Patienten. Hamostaseologie 31:111–117 CrossRefPubMed Weber C, Sanders JO, Friedrich K et al (2011) Stellenwert der Thromelastometrie für das Monitoring von Faktor XIII. Prospektive Observationsstudie bei neurochirurgischen Patienten. Hamostaseologie 31:111–117 CrossRefPubMed
66.
Zurück zum Zitat Whiting P, Al M, Westwood M et al (2015) Viscoelastic point-of-care testing to assist with the disgnosis, management and monitoring of haemostasis: a systematic review and cost-effectiveness analysis. Health Technol Assess 19(58):1–228 CrossRefPubMedPubMedCentral Whiting P, Al M, Westwood M et al (2015) Viscoelastic point-of-care testing to assist with the disgnosis, management and monitoring of haemostasis: a systematic review and cost-effectiveness analysis. Health Technol Assess 19(58):1–228 CrossRefPubMedPubMedCentral
Metadaten
Titel
Moderne Gerinnungstherapie beim blutenden Schwerverletzten
Faktorengabe nach „Point-of-care“
verfasst von
Prof. Dr. med. Marc Maegele
Publikationsdatum
26.08.2019
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 4/2019
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-019-00300-9