{"id":9212,"date":"2019-05-01T04:31:45","date_gmt":"2019-05-01T02:31:45","guid":{"rendered":"http:\/\/news-papers.eu\/?p=9212"},"modified":"2019-04-28T14:59:09","modified_gmt":"2019-04-28T12:59:09","slug":"european-bleeding-guideline-5-auflage-teil-3","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=9212","title":{"rendered":"European bleeding guideline, 5. Auflage &#8211; Teil 4"},"content":{"rendered":"<blockquote><p><strong><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"9203\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=9203\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1892%2C682&amp;ssl=1\" data-orig-size=\"1892,682\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Bildschirmfoto 2019-03-30 um 11.38.16\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1024%2C369&amp;ssl=1\" class=\"alignnone wp-image-9203\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?resize=633%2C228\" alt=\"\" width=\"633\" height=\"228\" srcset=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?resize=300%2C108&amp;ssl=1 300w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?resize=768%2C277&amp;ssl=1 768w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?resize=1024%2C369&amp;ssl=1 1024w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?resize=750%2C270&amp;ssl=1 750w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?w=1892&amp;ssl=1 1892w\" sizes=\"auto, (max-width: 633px) 100vw, 633px\" \/>Spahn DR et al. The European guideline on management of\u00a0major bleeding and coagulopathy\u00a0following trauma: fifth edition.\u00a0Critical Care (2019) 23:98\u00a0(<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-019-2347-3\" target=\"_blank\" rel=\"noopener\">PDF<\/a>)<\/strong><\/p><\/blockquote>\n<p><strong>Kernaussagen (freie \u00dcbersetzung):<\/strong><\/p>\n<p><strong>H\u00e4moglobin (Hb)<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Wir empfehlen einen <strong>niedrigen Hb-Wert als Marker<\/strong> f\u00fcr eine schwere Blutung mit assoziierter Koagulopathie heranziehen. (Grade 1B)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen die Nutzung von <strong>wiederholten Hb-Bestimmungen<\/strong> als einer laborchemischer Marker f\u00fcr eine Blutung, da der initiale Hb-Wert innerhalb des Normalbereichs eine Blutung maskieren kann. (Grade 1B)<\/li>\n<li>Wir empfehlen einen <strong>Ziel-Hb von 7-9 g\/dl<\/strong>. (Grade 1C)<\/li>\n<\/ul>\n<p><strong>Serumlaktat<\/strong><\/p>\n<ul>\n<li>Wir empfehlen das <strong>Serumlaktat<\/strong> und\/oder den <strong>Basendefizit<\/strong> als sensitive Tests und zum Monitoring f\u00fcr Blutung und Schock. (Grade 1B)<\/li>\n<\/ul>\n<p><strong>Gewebeoxygenierung<\/strong><\/p>\n<ul>\n<li>Wir empfehlen die <strong>permissive Hypotension<\/strong> mit einem <strong>systolischen Zielblutdruck von 80\u201390 mmHg<\/strong> (MAP 50\u201360mmHg) bis starke Blutungen gestoppt wurden, bei Patienten ohne Hirnverletzungen. (Grade 1C)<\/li>\n<li>Bei <strong>Patienten mit Sch\u00e4del-Hirntrauma<\/strong> (GCS \u22648) empfehlen wir einen <strong>MAP \u226580 mmHg<\/strong> aufrechtzuerhalten.\u00a0(Grade 1C)<\/li>\n<\/ul>\n<p><strong>Volumentherapie<\/strong><\/p>\n<ul>\n<li>Wir empfehlen eine <strong>restriktive Volumentherapie<\/strong> bis eine Blutung kontrolliert wird. \u00a0(Grade 1B).<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Spahn DR et al. The European guideline on management of\u00a0major bleeding and coagulopathy\u00a0following trauma: fifth edition.\u00a0Critical Care (2019) 23:98\u00a0(PDF) Kernaussagen (freie \u00dcbersetzung): H\u00e4moglobin (Hb) Wir empfehlen einen niedrigen Hb-Wert als [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":9203,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false},"categories":[1210],"tags":[186],"class_list":["post-9212","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blutungsmanagement","tag-blutung"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1892%2C682&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-2oA","jetpack-related-posts":[{"id":9218,"url":"https:\/\/news-papers.eu\/?p=9218","url_meta":{"origin":9212,"position":0},"title":"European bleeding guideline, 5. Auflage &#8211; Teil 3","author":"Michael Bernhard","date":"April 23, 2019","format":false,"excerpt":"Spahn DR et al. The European guideline on management of\u00a0major bleeding and coagulopathy\u00a0following trauma: fifth edition.\u00a0Critical Care (2019) 23:98\u00a0(PDF) Kernaussagen (freie \u00dcbersetzung): Vasopressoren und Katecholamine Beim Vorliegen einer lebensbedrohlichen Hypotension empfehlen wir den Einsatz von Vasopressoren und Vasopressoren mit Volumentherapie bis zum Erreichen eines arteriellen Zielblutdrucks.\u00a0(Grade 1C) Wir empfehlen die\u2026","rel":"","context":"In &quot;Blutungsmanagement&quot;","block_context":{"text":"Blutungsmanagement","link":"https:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":9209,"url":"https:\/\/news-papers.eu\/?p=9209","url_meta":{"origin":9212,"position":1},"title":"European bleeding guideline, 5. 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(Grade 1B) Wir empfehlen, dass die Zeit zwischen Verletzung und\u2026","rel":"","context":"In &quot;Blutungsmanagement&quot;","block_context":{"text":"Blutungsmanagement","link":"https:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":19106,"url":"https:\/\/news-papers.eu\/?p=19106","url_meta":{"origin":9212,"position":3},"title":"Should I stay or should I transfuse ?","author":"Bj\u00f6rn Hossfeld","date":"Januar 23, 2025","format":false,"excerpt":"Ein Gastbeitrag von Ferdinand Maier, Ulm \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Wann ist der richtige Zeitpunkt f\u00fcr eine Transfusion von Erythrozytenkonzentraten (EKs)? Dies Frage stellen sich vermutlich viele Kliniker. Sind dabei physiologische Werte besser geeignet, um diese Entscheidung zu treffen als H\u00e4moglobin (Hb)-basierte Grenzwerte? Um diese Frage zu beantworten, besch\u00e4ftigten sich Noitz et al.\u2026","rel":"","context":"In &quot;Transfusion&quot;","block_context":{"text":"Transfusion","link":"https:\/\/news-papers.eu\/?cat=204"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/02\/CHR22-RTH-Blut-EKs-KNO%CC%88FEL-01-0--scaled-e1737198382880.jpg?fit=776%2C977&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/02\/CHR22-RTH-Blut-EKs-KNO%CC%88FEL-01-0--scaled-e1737198382880.jpg?fit=776%2C977&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/02\/CHR22-RTH-Blut-EKs-KNO%CC%88FEL-01-0--scaled-e1737198382880.jpg?fit=776%2C977&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/02\/CHR22-RTH-Blut-EKs-KNO%CC%88FEL-01-0--scaled-e1737198382880.jpg?fit=776%2C977&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":18715,"url":"https:\/\/news-papers.eu\/?p=18715","url_meta":{"origin":9212,"position":4},"title":"Restriktive Transfusionsindikation: immer &#038; f\u00fcr alle?","author":"Bj\u00f6rn Hossfeld","date":"Oktober 27, 2024","format":false,"excerpt":"Ein Gastbeitrag von Heiko Lier, K\u00f6ln \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Eine zur\u00fcckhaltende, restriktive Transfusionsindikation hat sich bei praktisch allen Patientengruppen als sinnvoll, d.h. nicht nachteilig aber Erythrozytenkonzentrate (EK) sparend, gezeigt. 2020 ver\u00f6ffentlichte die B\u00c4K erstmals Empfehlungen zur Indikation von Transfusionen (und teilweise auch deren Zielbereich) bei hospitalisierten Patienten [5]. Eine restriktive Indikation bei\u2026","rel":"","context":"In &quot;Transfusion&quot;","block_context":{"text":"Transfusion","link":"https:\/\/news-papers.eu\/?cat=204"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2024\/10\/Blut-OP-scaled.jpg?fit=1200%2C900&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2024\/10\/Blut-OP-scaled.jpg?fit=1200%2C900&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2024\/10\/Blut-OP-scaled.jpg?fit=1200%2C900&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2024\/10\/Blut-OP-scaled.jpg?fit=1200%2C900&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2024\/10\/Blut-OP-scaled.jpg?fit=1200%2C900&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":4297,"url":"https:\/\/news-papers.eu\/?p=4297","url_meta":{"origin":9212,"position":5},"title":"Surviving Sepsis Campaign 2017 &#8211; Teil 2","author":"Michael Bernhard","date":"April 17, 2017","format":false,"excerpt":"Die 2016er\u00a0\"Surviving Sepsis Campaign\" Empfehlungen zur Behandlung der Sepsis sind publiziert worden. Wir sind bereits in einem ersten Teil auf einige Punkte eingegangen, nun weitere Aspekte:\u00a0Lesen Sie die komplette Leitlinie unter:\u00a0PDF KORIKOSTEROIDE kein Hydrokortison, wenn Volumen- und Vasopressortherapie zur h\u00e4modynamischen Stabilit\u00e4t f\u00fchren; bei persistierender h\u00e4modynamischer Instabilit\u00e4t ist \u00a0200mg Hydrokortison als\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/01\/Bildschirmfoto-2017-01-23-um-07.57.24-e1485154716876.png?fit=500%2C343&ssl=1&resize=350%2C200","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9212","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9212"}],"version-history":[{"count":7,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9212\/revisions"}],"predecessor-version":[{"id":9390,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9212\/revisions\/9390"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/9203"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9212"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9212"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9212"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}