ROTEM？-guided coagulation factor concentrate therapy in trauma 2-year experience in Venice, Italy 英文参考文献.docVIP

Grassetto et al. Critical Care 2012, 16:428 /content/16/3/428 LETTER ROTEM?-guided coagulation factor concentrate therapy in trauma: 2-year experience in Venice, Italy Alberto Grassetto*, Marco De Nardin, Bernadetta Ganzerla, Monica Geremia, Debora Saggioro, Elena Sera? ni, Silvia Zampieri, Manuela To? oli, Daniele Penzo, Antonio Bossi and Carlo Maggiolo Haemostatic therapy for trauma-induced coagulopathy is poor clinical outcome. Our experience also suggests that typically based on administration of allogeneic blood patients with massive bleeding may bene? t from imme- products, although the evidence supporting this approach is poor [1]. Fixed-ratio protocols have been proposed for diate, proactive administration of 1 g tranexamic acid followed by 2 to 4 g ? brinogen concentrate, with further administering fresh frozen plasma, red blood cells and doses as soon as ROTEM? results are available. platelets, but the optimal ratio has not been established and the speed of intervention may be more important [2]. In contrast to ? xed-ratio treatment, coagulation factor Fibrinogen concentrate is currently imported in Italy and we use it according to the manufacturer’s label. In some countries the product is licensed only for congenital concentrate therapy guided by point-of-care monitoring de? ciency. However, it is possible to use life-saving drugs allows patients’ actual needs to be targeted [3]. Our initial experience with ROTEM? (Tem International GmbH, Munich, Germany) indicated correlation between the clinical condition and extent of coagulo pathy, suggesting for indications beyond the label, providing the physician is convinced that this use is in the patient’s best interest; such practice is regulated by health authorities in several countries. High-quality, randomised controlled trials are a need for the early identi? cation and treatment of lacking for