Transfusion interventions in critical bleeding requiring massive transfusion: a systematic review.

摘要: Critical bleeding (CB) requiring massive transfusion (MT) can occur in a variety of clinical contexts and is associated with substantial mortality morbidity. In 2011, the Australian National Blood Authority (NBA) published patient blood management guidelines for CB MT, which found limited high-quality evidence from only 2 recommendations could be made. The aim this systematic review (SR) was to update these identify gaps still addressed. A comprehensive search performed randomized controlled trials (RCTs) SRs using MeSH index free text terms MEDLINE, Cochrane Library (Issue 11, 2012), EMBASE, CINHAL, PUBMED, Transfusion Evidence up July 15, 2014. grouped according 4 questions based on original guideline relating interventions: (1) effect dose, timing, ratio red cells (RBCs) component therapy outcomes; (2) RBC (3) fresh frozen plasma, platelet, cryoprecipitate, fibrinogen concentrate, prothrombin complex concentrate (4) recombinant activated factor VII (rFVIIa) outcomes. From search, 19 studies were identified: 6 RCTs 13 SRs. Two pilot/feasibility studies, 3 investigating rFVIIa, 1 compared restrictive versus liberal upper gastrointestinal hemorrhage. Overall, new identified remain, particularly regard therapies, including Clinical address are required.