Abstract：
Severe trauma represents a major global public health burden and the management of post-traumatic bleeding continues to challenge healthcare systems around the world. Post-traumatic bleeding and associated traumatic coagulopathy remain leading causes of potentially preventable multiorgan failure and death if not diagnosed and managed in an appropriate and timely manner. This sixth edition of the European guideline on the management of major bleeding and coagulopathy following traumatic injury aims to advise clinicians who care for the bleeding trauma patient during the initial diagnostic and therapeutic phases of patient management.
The pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma included representatives from six European professional societies and convened to assess and update the previous version of this guideline using a structured, evidence-based consensus approach. Structured literature searches covered the period since the last edition of the guideline, but considered evidence cited previously. The format of this edition has been adjusted to reflect the trend towards concise guideline documents that cite only the highest-quality studies and most relevant literature rather than attempting to provide a comprehensive literature review to accompany each recommendation.
This guideline comprises 39 clinical practice recommendations that follow an approximate temporal path for management of the bleeding trauma patient, with recommendations grouped behind key decision points. While approximately one-third of patients who have experienced severe trauma arrive in hospital in a coagulopathic state, a systematic diagnostic and therapeutic approach has been shown to reduce the number of preventable deaths attributable to traumatic injury.
A multidisciplinary approach and adherence to evidence-based guidelines are pillars of best practice in the management of severely injured trauma patients. Further improvement in outcomes will be achieved by optimising and standardising trauma care in line with the available evidence across Europe and beyond.
The pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma included representatives from six European professional societies and convened to assess and update the previous version of this guideline using a structured, evidence-based consensus approach. Structured literature searches covered the period since the last edition of the guideline, but considered evidence cited previously. The format of this edition has been adjusted to reflect the trend towards concise guideline documents that cite only the highest-quality studies and most relevant literature rather than attempting to provide a comprehensive literature review to accompany each recommendation.
This guideline comprises 39 clinical practice recommendations that follow an approximate temporal path for management of the bleeding trauma patient, with recommendations grouped behind key decision points. While approximately one-third of patients who have experienced severe trauma arrive in hospital in a coagulopathic state, a systematic diagnostic and therapeutic approach has been shown to reduce the number of preventable deaths attributable to traumatic injury.
A multidisciplinary approach and adherence to evidence-based guidelines are pillars of best practice in the management of severely injured trauma patients. Further improvement in outcomes will be achieved by optimising and standardising trauma care in line with the available evidence across Europe and beyond.
摘要：
背景：严重创伤是全球主要的公共卫生负担，创伤后出血的管理继续挑战着世界各地的医疗保健系统。创伤后出血和相关的创伤性凝血病仍然是潜在可预防的多器官衰竭和死亡的主要原因，如果没有以适当和及时的方式诊断和管理。欧洲关于外伤后大出血和凝血病管理的第六版指南旨在为在患者管理的初始诊断和治疗阶段护理出血创伤患者的临床医生提供建议。
方法：泛欧，创伤高级出血护理多学科工作组包括来自六个欧洲专业协会的代表，并召开会议，使用结构化的方法评估和更新本指南的先前版本，基于证据的共识方法。结构化文献检索涵盖了自上次指南以来的时期，但考虑到之前引用的证据。此版本的格式已进行了调整，以反映简明扼要的指南文件的趋势，这些指南文件仅引用最高质量的研究和最相关的文献，而不是试图提供全面的文献综述来伴随每个建议。
结果：本指南包含39项临床实践建议，这些建议遵循出血创伤患者的大致时间路径，建议分组在关键决策点之后。虽然大约三分之一经历过严重创伤的患者在凝血状态下住院，系统的诊断和治疗方法已被证明可以减少因外伤导致的可预防死亡的数量.
结论：多学科方法和对循证指南的坚持是治疗严重创伤患者的最佳实践的支柱。根据欧洲及其他地区的现有证据，通过优化和标准化创伤护理将进一步改善结果。
方法：泛欧，
结果：本指南包含39项临床实践建议，这些建议遵循出血创伤患者的大致时间路径，
结论：多学科方法和对循证指南的坚持是治疗严重创伤患者的最佳实践的支柱。
