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Blood transfusion management in the severely bleeding military patient

机译：严重出血军事患者的输血管理

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Purpose of reviewHemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient. Understanding the life-threatening nature of coagulopathy of trauma and implementing strategies aimed at full spectrum hemorrhage management from point of injury to postoperative care will result in improved outcomes in patients with life-threatening bleeding.Recent findingsTimely and appropriate therapies impact survival. Blood product resuscitation for life-threatening hemorrhage should either be with whole blood or a component therapy strategy that recapitulates the functionality of whole blood. The US military has transfused over 10000 units of whole blood since the beginning of the wars in Iraq and Afghanistan. The well recognized therapeutic benefits of whole blood have pushed this therapy far forward into prehospital care in both US and international military forces. Multiple hemostatic adjuncts are available that are likely beneficial to the bleeding military patient; and other products and techniques are under active investigation.SummaryLessons learned in the treatment of combat casualties will likely continue to have positive impact and influence and the management of hemorrhage in the civilian trauma setting.
机译：审查目的仍然是战场上可预防死亡和民用创伤的主要原因。出血控制是多因素，并以伤害点护理开始。手术出血控制和从伤害到手术的时间是至关重要的;但是，在前孢子环境和围手术期的干预影响结果。本综述的目的是了解成功管理出血军事患者的概念和策略。了解创伤的凝血性的危及生命性质，并从术后护理人员伤害造成全谱出血管理的策略将导致危及生命的出血的患者的结果改善。感染效果和适当的疗法会影响生存。血液产品危及危及生命出血的复苏应具有全血或组件治疗策略，可概括全血的功能。自伊拉克和阿富汗战争开始以来，美国军方已转发超过10000个全血。全血的良好认可的治疗益处推动了这一疗法在美国和国际军队的前期护理中远远进入。可以使用多种止血附件，这可能有利于出血的军事患者;和其他产品和技术在积极调查下。在战斗伤亡人员的治疗中，ummary不可能在平民创伤环境中继续产生积极的影响和影响和血液检测。

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