创伤失血性休克诊治中国急诊专家共识

doi:10.3969/j.issn.1002-1949.2017.12.002

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (12): 1075-1082 DOI: 10.3969/j.issn.1002-1949.2017.12.002

Chinese emergency medicine expert concensus on diagnosis and treatment of traumatic hemorrhagic shock

Abstract
Figure/Table
References (53)
Related Citation (15)

［1］WHO. Global heath estimates 2014 summary tables: deaths by cause, age and sex. Violence　and injury, 2000-2012. ［2］Kauvar DS, Lefering R, Wade CE. Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations［J］. J Trauma, 2006, 60(6 Suppl): S3-11. ［3］Gruen RL, Brohi K, Schreiber M, et al. Haemorrhage control in severely injured patients［J］. Lancet, 2012, 380(9847): 1099-1108. ［4］Yi J, Slaughter A, Kotter CV, et al. A “clean case” of systemic injury: mesenteric lymph after hemorrhagic shock elicits a sterile inflammatory response［J］. Shock, 2015, 44(4): 336-340. ［5］Manson J, Thiemermann C, Brohi K. Trauma alarmins as activators of damage-induced inflammation［J］. Br J Surg, 2012, 99(Suppl 1): 12-20. ［6］Rossaint R, Bouillon B, Cerny V, et al. The European guideline on management of　major bleeding and coagulopathy following trauma: fourth edition［J］. Crit Care, 2016, 20: 100. ［7］Bickell WH, Wall MJ JR, Pepe PE, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries［J］. N Engl J Med, 1994, 331(17): 1105-1109. ［8］Collaborators CT, Shakur H, Roberts I, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial［J］. Lancet, 2010, 376(9734): 23-32. ［9］Spahn DR, Bouillon B, Cerny V, et al. Management of bleeding and coagulopathy following major trauma: an updatedEuropean guideline［J］. Crit Care, 2013, 17(2): R76. ［10］Gelman S, Mushlin PS. Catecholamine-induced changes in the splanchnic circulation affecting systemichemodynamics［J］. Anesthesiology, 2004, 100(2): 434-439. ［11］Olaussen A, Blackburn T, Mitra B, et al. Review article: shock index for prediction of critical bleeding post-trauma: a systematic review［J］. Emerg Med Australas, 2014, 26 (3): 223-228. ［12］Pearson JD, Roun JA, Ingram M. Management of shock in trauma［J］. Anaesthes Intens Care Med, 2014, 15(9): 408-410. ［13］Chapleau W, Al-khatib J, Haskin D, et al. Advanced trauma life support (ATLS): the ninth edition［J］. J Trauma Acute Care Surg, 2013, 74(5): 1363-1366. ［14］Cecconi M, De Backer D, Antonelli M, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine ［J］.Intensive Care Med, 2014, 40(12): 1795-1815. ［15］Rossaint R, Bouillon B, Cerny V, et al. Management of bleeding following major trauma: an updated European guideline［J］. Crit Care, 2010, 14(2): R52. ［16］Ibrahim I, Chor WP, Chue KM, et al. Is arterial base deficit still a useful prognostic marker in trauma A systematic review［J］. Am J Emerg Med, 2016, 34(3): 626-635. ［17］Ouellet JF, Roberts DJ, Tiruta C, et al. Admission base deficit and lactate levels in Canadian patients with blunt trauma: are they useful markers of mortality［J］. J Trauma Acute Care Surg, 2012, 72(6): 1532-1535. ［18］Mikkelsen ME, Miltiades AN, Gaieski DF, et al. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock［J］. Crit Care Med, 2009, 37(5): 1670-1677. ［19］Jansen TC, Van Bommel J, Schoonderbeek FJ, et al. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial［J］. Am J Respir Crit Care Med, 2010, 182(6): 752-761. ［20］NICE guideline. Major trauma: Assessment and Initial Management. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK); 2016. ［21］Knaus WA, Draper EA, Wagner DP, et al. APACHE Ⅱ: a severity of disease classification system［J］. Crit Care Med, 1985, 13(10): 818-829. ［22］Vincent JL, De Backer D, Circulatory Shock［J］. N Engl J Med, 2013, 369(18): 1726-1734. ［23］Mayglothling J, Duane TM, Gibbs M, et al. Emergency tracheal intubation immediately following traumatic injury: An Eastern Association for the Surgery of Trauma practice management guideline［J］. J Trauma Acute Care Surg, 2012,73(5 Suppl 4): S333-340. ［24］Holly LT, Kelly DF, Counelis GJ, et al. Cervical spine trauma associated with moderate and severe head injury: incidence, risk factors, and injury characteristics［J］. J Neurosurg, 2002, 96(3 Suppl) : 285-291. ［25］Kelly JM, Callum JL, Rizoli SB. 1:1:1 - Warranted or wasteful Even where appropriate, high ratio transfusion protocols are costly: early transition to individualized care benefits patients and transfusion services［J］. Expert Rev Hematol, 2013, 6(6): 631-633. ［26］Jenkins D, Rhee P, Johannigman J, et al. Damage control resuscitation: directly addressing the early coagulopathy of trauma［J］. J Trauma, 2007, 62(2): 307-310. ［27］Ketchum L, Hess JR, HⅡppala S. Indications for early fresh frozen plasma, cryoprecipitate, and platelet transfusion in trauma［J］. J Trauma, 2006, 60(6 Suppl): S51-58. ［28］Neal MD, Hoffman MK, Cuschieri J, et al. Crystalloid to packed red blood cell transfusion ratio in the massively transfused patient: when a little goes a long way［J］. J Trauma Acute Care Surg, 2012, 72(4): 892-898. ［29］Palmer L. Fluid management in patients with trauma: Restrictive versus liberal approach［J］. Vet Clin North Am Small Anim Pract. 2017, 47(2):397-410.  ［30］Pre-hospital initiation of fluid replacement therapy in trauma Technology appraisal guidance Published date: 28 January 2004. https://www.nice.org.uk/guidance/ta74 ［31］Butler FK, Holcomb JB, Schreiber MA, et al. Fluid Resuscitation for Hemorrhagic Shock in Tactical Combat Casualty Care: TCCC Guidelines Change 14-01-2 June 2014［J］. J Spec Oper Med, 2014, 14(3): 13-38. ［32］Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial［J］. Lancet, 2010, 376(9734): 23-32. ［33］Significant haemorrhage following trauma: tranexamic acid Evidence summary ［ESUOM1］Published date: October 2012. https://www.nice.org.uk/advice/esuom1/chapter/Key-points-from-the-evidence ［34］Luo Y, Liu Q, Jiao Z, et al. A comparison study of local injection and radiofrequency ablation therapy for traumatic portal vein injure guided by contrast-enhanced ultrasonography［J］. Ann Hepatol, 2012, 11(2): 249-256. ［35］Wang T, Wang DN, Liu WT, et al. Hemostatic effect of topical hemocoagulase spray in digestive endoscopy［J］. World J Gastroe〖JP〗nterol, 2016, 22(25): 5831-5836. ［36］Kessler CM. Urgent reversal of warfarin with prothrombin complex concentrate: where are the evidence-based data［J］. J Thromb Haemost, 2006, 4(5): 963-966. ［37］Bruce D, Nokes TJ. Prothrombin complex concentrate (Beriplex P/N) in severe bleeding: experience in a large tertiary hospital［J］. Crit Care, 2008, 12(4): R105. ［38］Huynh TK, Costello JL, Rebuck JA. Optimizing the dose of three-factor prothrombin complex concentrate in traumatic brain injury patients on warfarin therapy［J］. Pharmacotherapy, 2014, 34(3): 260-264. ［39］Kerebel D, Joly LM, Honnart D, et al. A French multicenter randomised trial comparing two dose-regimens of prothrombin complex concentrates in urgent anticoagulation reversal［J］. Crit Care, 2013, 17(1): R4. ［40］Vincent JL, De Backer D. Circulatory shock［J］. New Engl J Med, 2013, 369(18): 1726-1734. ［41］Maegele M, Schochl H, Cohen MJ. An update on the coagulopathy of trauma［J］. Shock, 2014, 41 (Suppl 1): 21-25. ［42］Maegele M, Spinella PC, Sch chl H. The acute coagulopathy of trauma: mechanisms and tools for risk stratification［J］. Shock, 2012, 38(5): 450-458. ［43］Soar J, Perkins GD, Abbas G, et al. European resuscitation council guidelines for resuscitation 2010 section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution［J］. Resuscitation, 2010, 81(10): 1400-1433. ［44］Tsuei BJ, Kearney PA. Hypothermia in the trauma patient［J］. Injury, 2004, 35(1): 7-15. ［45］Balvers K, Van der Horst M, Graumans M. Hypothermia as a predictor for mortality in trauma patients at admittance to the Intensive Care Unit［J］. J Emerg Trauma Shock, 2016, 9(3): 97-102. ［46］Scholten AC, Berben SA, Westmaas AH, et al. Pain management in trauma patients in (pre)hospital based emergency care: Current practice versus new guideline［J］. Injury, 2015, 46(5): 798-806.  ［47］Bounes V, Barthélémy R, Diez O, et al. Sufentanil Is Not Superior to Morphine for the Treatment of Acute Traumatic Pain in an Emergency Setting: A Randomized, Double-Blind, Out-of-Hospital Tria［J］. Annals Emerg Med, 2010, 56(5): 509-516. ［48］Craig M, Jeavons R, Probert J, et al. Randomised comparison of intravenous paracetamol and intravenous morphine for acute traumatic limb pain in the emergency department［J］. Emerg Med J, 2012, 29(1): 37-39. ［49］Michael MD, Wang Y, Cudnik M, et al. The Effectiveness and Adverse Events of Morphine versus Fentanyl on a Physician-staffed Helicopter［J］. J Emerg Med, 2010, 43(1): 69-75. ［50］Jennings PA, Cameron P, Bernard S. Ketamine as an analgesic in the pre-hospital setting: a systematic review［J］. Acta Anaesthesiol Scand, 2011, 55(6): 638-643. ［51］Farsi D, Movahedi M, Hafezimoghadam P, et al. Acute pain management with intravenous 0.10 mg/kg vs. 0.15 mg/kg morphine sulfate in limb traumatized patients: a randomized double blinded placebo-controlled trial［J］. Ulus Travma Acil Cerrahi Derg, 2013, 19(5): 398-404. ［52］Park KH, Lee KH, Kim H, et al. The anti-inflammatoryeffects of ulinastatin in trauma patients with hemorrhagicshock ［J］. J Koreanmedical Science, 2010, 25(1): 128-134. ［53］Hui L, Shen F, Chang H, et al. Effects of ulinastatin on cerebral oxygen metabolism and CRP levels in patients with severe traumatic brain injury［J］. Exp Ther Med, 2014, 7(6): 1683-1686.