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Blutungen und Gerinnungsstörungen beim Polytrauma

Aktueller Stand der Diagnostik und des Managements bei traumaassoziierten Koagulopathien

Bleeding and coagulation disorders in polytrauma patients

Current status in the diagnosis and management of trauma-associated coagulopathy

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Zusammenfassung

Hintergrund

Unkontrollierbare Blutungen sind eine der führenden Todesursachen beim Traumapatienten.

Fragestellung

Die Entwicklungen und Empfehlungen der Akuttherapie traumatischer Blutungen sollen dargestellt werden.

Material und Methode

Übersichtsarbeit unter Berücksichtigung aktueller Studien und den 2013 überarbeiteten „European Guidelines“.

Ergebnisse

Klare Empfehlungen hinsichtlich Basis- und erweiterter Diagnostik, externer Maßnahmen und Substitution von Gerinnungs- und Blutprodukten können gegeben werden.

Schlussfolgerung

Kliniken der Traumaversorgung sollten einen individuellen, an die lokalen Gegebenheiten und internationalen Empfehlungen angelehnten Algorithmus zur Therapie der traumaassoziierten Koagulopathie vorhalten.

Abstract

Background

Uncontrolled hemorrhage is one of the leading causes of death in trauma patients.

Objective

The purpose of this article is to present and discuss current developments and recommendations regarding the acute treatment of bleeding trauma patients.

Materials and methods

A review of recent studies and the 2013 update of the European Guidelines are presented.

Results

Clear recommendations regarding basic and advanced diagnostic procedures and interventions are given.

Conclusion

Hospitals involved in trauma care should have an individual algorithm for the treatment of bleeding patients, based on international guidelines and adapted to local circumstances.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. S. Wutzler, M. Maegele, T. Lustenberger, F. Hildebrand, R. Lefering, M. Frink und I. Marzi geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt am Main, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Deutschland

    S. Wutzler, T. Lustenberger & I. Marzi

  2. Institut für Forschung in der Operativen Medizin (IFOM), Private Universität Witten/Herdecke, Campus Köln-Merheim, Witten, Deutschland

    M. Maegele & R. Lefering

  3. Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland

    F. Hildebrand

  4. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Standort Marburg, UKGM, Marburg, Deutschland

    M. Frink

Authors
  1. S. Wutzler
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  2. M. Maegele
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  3. T. Lustenberger
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  4. F. Hildebrand
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  5. R. Lefering
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  6. M. Frink
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  7. I. Marzi
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Die Sektion Trauma der DIVI

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Correspondence to S. Wutzler.

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Wutzler, S., Maegele, M., Lustenberger, T. et al. Blutungen und Gerinnungsstörungen beim Polytrauma. Notfall Rettungsmed 17, 567–574 (2014). https://doi.org/10.1007/s10049-014-1863-6

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  • DOI: https://doi.org/10.1007/s10049-014-1863-6

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