Contemporary management of major haemorrhage in critical care

Cheryl L. Maier, Karim Brohi, Nicola Curry, Nicole P. Juffermans, Lidia Mora Miquel, Matthew D. Neal, Beth H. Shaz, Alexander P. J. Vlaar, Julie Helms

Research output: Contribution to journalReview articleAcademicpeer-review

3 Citations (Scopus)

Abstract

Haemorrhagic shock is frequent in critical care settings and responsible for a high mortality rate due to multiple organ dysfunction and coagulopathy. The management of critically ill patients with bleeding and shock is complex, and treatment of these patients must be rapid and definitive. The administration of large volumes of blood components leads to major physiological alterations which must be mitigated during and after bleeding. Early recognition of bleeding and coagulopathy, understanding the underlying pathophysiology related to specific disease states, and the development of individualised management protocols are important for optimal outcomes. This review describes the contemporary understanding of the pathophysiology of various types of coagulopathic bleeding; the diagnosis and management of critically ill bleeding patients, including major haemorrhage protocols and post-transfusion management; and finally highlights recent areas of opportunity to better understand optimal management strategies for managing bleeding in the intensive care unit (ICU).
Original languageEnglish
Pages (from-to)319-331
Number of pages13
JournalIntensive care medicine
Volume50
Issue number3
Early online date2024
DOIs
Publication statusPublished - Mar 2024

Keywords

  • Bleeding
  • Coagulopathy
  • Critical illness
  • Haemorrhage
  • Massive transfusion

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