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European Journal of Trauma and Emergency Surgery

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Open Access 01-06-2016 | Original Article

Pharmacological adjuncts to stop bleeding: options and effectiveness

Authors: M. Panteli, I. Pountos, P. V. Giannoudis

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2016

Abstract

Severe trauma and massive haemorrhage represent the leading cause of death and disability in patients under the age of 45 years in the developed world. Even though much advancement has been made in our understanding of the pathophysiology and management of trauma, outcomes from massive haemorrhage remain poor. This can be partially explained by the development of coagulopathy, acidosis and hypothermia, a pathological process collectively known as the “lethal triad” of trauma. A number of pharmacological adjuncts have been utilised to stop bleeding, with a wide variation in the safety and efficacy profiles. Antifibrinolytic agents in particular, act by inhibiting the conversion of plasminogen to plasmin, therefore decreasing the degree of fibrinolysis. Tranexamic acid, the most commonly used antifibrinolytic agent, has been successfully incorporated into most trauma management protocols effectively reducing mortality and morbidity following trauma. In this review, we discuss the current literature with regard to the management of haemorrhage following trauma, with a special reference to the use of pharmacological adjuncts. Novel insights, concepts and treatment modalities are also discussed.

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Title: Pharmacological adjuncts to stop bleeding: options and effectiveness
Authors: M. Panteli
I. Pountos
P. V. Giannoudis
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2016
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-015-0613-x

At a glance: The STEP trials

Springer Medicine

Pharmacological adjuncts to stop bleeding: options and effectiveness

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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