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Massive Transfusion and Coagulopathy: Can We Stop the Bloody Vicious Cycle?

Release Date: December 1, 2006

Expiration Date: December 1, 2007

Estimated time to complete this Activity: 1.5 hours

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Overview

Patients with massive traumatic hemorrhage inevitably develop coagulopathy as a result of hemodilution and consumption of platelets and clotting factors. This acquired coagulopathy is further exacerbated by hypothermia and acidosis—the “bloody vicious cycle.” Using laboratory-guided replacement therapy to correct this coagulopathy is not feasible in trauma patients with rapid ongoing hemorrhage and blood replacement. Empiric strategies, such as massive transfusion protocols, concurrently infuse red blood cells, plasma, and platelets in fixed ratios without waiting for laboratory results. Massive transfusions, however, reinforce existing coagulopathy and absorb more than half of all of the blood used in injury care in a trauma center. Consensus about the optimal transfusion protocol is lacking, which can create controversy between trauma teams and transfusion services. During this symposium, the faculty will use a clinical case to illustrate the perspectives of the trauma team and transfusion services regarding strategies for resuscitation and hemostatic control in trauma patients with ongoing massive hemorrhage.

Target Audience

This activity is intended for transfusion medicine specialists, blood bankers, laboratory technicians, and other health care professionals interested in the management of hemostasis in trauma patients with massive hemorrhage.

Learning Objectives

After completing this continuing medical education (CME) activity, participants should be able to:

• Explain the coagulopathic processes associated with traumatic hemorrhage
• Describe the roles of the trauma team and transfusion services in massive transfusion protocols
• Evaluate hemostatic strategies to control massive hemorrhage

Accreditation Statement

This activity has expired.

Designation Statement

This activity has expired.

How to Get Credit

This activity has expired.

Faculty Disclosure

It is the policy of the FCG Institute for Continuing Education that all faculty participating in continuing medical education activities are expected to disclose to the program audience (1) any real or apparent conflict(s) of interest related to the content of their presentation and (2) discussion of unlabeled or unapproved uses of drugs or medical devices. Faculty disclosure statements can be found with their biographical sketches, John R. Hess, MD, MPH, FACP, FAAAS, Richard P Dutton, MD, MBA, Ira A. Shulman, MD.

Conflict of Interest Resolution

When individuals in a position to control or influence the development of the content have reported Financial Relationships with one or more commercial interests, The FCG Institute for Continuing Education utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias. The content of this presentation was vetted through The Institute's process of peer review and content validation and modified as required to meet this standard.

Notice About Investigational or Off-Label Use

This educational activity may include discussion of drugs or devices or uses of drugs and devices, that have not been approved by the FDA or have been approved by the FDA for specific uses only. It is the responsibility of the physician to determine the FDA clearance status of each drug or device he or she wishes to use in clinical practice. The FCG Institute for Continuing Education is committed to the free exchange of medical education. Inclusion of any product or device discussion, including discussion of investigational or off-label uses, does not imply endorsement by The Institute of the uses, products, or techniques presented.

Disclaimer

This CME/CE activity is designed for use by healthcare professionals for educational purposes only. The information and opinions expressed by the faculty are their own and do not necessarily reflect those of The FCG Institute. The FCG Institute for Continuing Education does not define a standard of care, nor does it intend to dictate an exclusive course of management but presents through the educational activities it sponsors recognized methods and techniques of clinical practice for consideration by physicians and other healthcare providers for incorporation into their practices. Participants should use their own clinical judgment before applying information, whether provided here or by others, for any professional use.

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Sponsored by: The FCG Institute for Continuing Education

The FCG Institute for Continuing Education
gratefully acknowledges an educational grant from
Novo Nordisk Inc. in support of this Web Site