原创力文档the acute management of trauma hemorrhage a systematic review of randomized controlled trials急性创伤出血的管理随机对照试验的系统评价.pdfVIP
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the acute management of trauma hemorrhage a systematic review of randomized controlled trials急性创伤出血的管理随机对照试验的系统评价
Curry et al. Critical Care 2011, 15:R92
/content/15/2/R92
RESEARCH Open Access
The acute management of trauma hemorrhage:
a systematic review of randomized controlled trials
1* 2,3 2 4 5 1
Nicola Curry , Sally Hopewell , Carolyn Dorée , Chris Hyde , Karim Brohi , Simon Stanworth
Abstract
Introduction: Worldwide, trauma is a leading cause of death and disability. Haemorrhage is responsible for up to
40% of trauma deaths. Recent strategies to improve mortality rates have focused on optimal methods of early
hemorrhage control and correction of coagulopathy. We undertook a systematic review of randomized controlled
trials (RCT) which evaluated trauma patients with hemorrhagic shock within the first 24 hours of injury and
appraised how the interventions affected three outcomes: bleeding and/or transfusion requirements; correction of
trauma induced coagulopathy and mortality.
Methods: Comprehensive searches were performed of MEDLINE, EMBASE, CENTRAL (The Cochrane Library Issue 7,
2010), Current Controlled Trials, ClinicalT, the World Health Organization International Clinical Trials Registry
Platform (ICTRP) and the National Health Service Blood and Transplant Systematic Review Initiative (NHSBT SRI) RCT
Handsearch Database.
Results: A total of 35 RCTs were identified which evaluated a wide range of clinical interventions in trauma
hemorrhage. Many of the included studies were of low methodological quality and participant numbers were
small. Bleeding outcomes were reported in 32 studies; 7 reported significantly reduced transfusion use following a
variety of clinical interventions, but this was not accompanied by improved survival. Minimal information was
found on traumatic coagulopathy across the ide
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