{"id":9218,"date":"2019-04-23T04:36:30","date_gmt":"2019-04-23T02:36:30","guid":{"rendered":"http:\/\/news-papers.eu\/?p=9218"},"modified":"2019-04-24T11:17:34","modified_gmt":"2019-04-24T09:17:34","slug":"european-bleeding-guideline-5-auflage-teil-4","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=9218","title":{"rendered":"European bleeding guideline, 5. Auflage &#8211; Teil 3"},"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-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=300%2C108&amp;ssl=1\" 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=622%2C224\" alt=\"\" width=\"622\" height=\"224\" 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: 622px) 100vw, 622px\" \/>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>Vasopressoren und Katecholamine<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Beim Vorliegen einer lebensbedrohlichen Hypotension empfehlen wir den Einsatz von <strong>Vasopressoren<\/strong> und <strong>Vasopressoren mit Volumentherapie<\/strong> bis zum Erreichen eines arteriellen Zielblutdrucks.\u00a0(Grade 1C)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen die kontinuierliche Inotropikazuf\u00fchrung beim Vorliegen einer myokardialen Dysfunktion. (Grade 1C)<\/li>\n<\/ul>\n<p><strong>W\u00e4rmeerhalt<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Um die Koagulation zu optimieren empfehlen wir W\u00e4rmeverluste zu vermeiden um eine <strong>Normothermie<\/strong> aufrechtzuerhalten. (Grade 1C)<\/li>\n<\/ul>\n<p><strong>Tranexams\u00e4ure (TXA)<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Wir empfehlen die Applikation von TXA <strong>beim blutenden Traumapatienten<\/strong> (oder bei einem signifikanten Risiko der Blutung) so rasch wie m\u00f6glich binnen 3 h nach Verletzung mit einer <strong>Loading-Doris von 1 g \u00fcber 10 min<\/strong>, gefolgt von 1 g \u00fcber 8 h. .\u00a0(Grade 1A)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen, dass Managementprotokolle bei blutenden Patienten die erste TXA Gabe <strong>auf dem Weg ins Krankenhau<\/strong>s beinhalten. (Grade 1C)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen, dass die Gabe von TXA nicht die Ergebnisse von Viscoelastischen Testverfahren abwartet. (Grade 1B)<\/li>\n<\/ul>\n<p><strong>FFP-Gabe<\/strong><\/p>\n<ul>\n<li style=\"text-align: justify;\">Wenn FFP-basierte Gerinnungstherapiestrategien genutzt werden, empfehlen wir, dass FFP-Gabe sich nach den Standardlaborkoagulationsparameter richten\u00a0(PT und\/oder APTT &gt; 1,5 fache der Norm und\/oder Viscoelastic Evidence eines Defizits besteht). (Grade 1C)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen, dass die FFP Transfusion bei Patienten ohne Blutung vermieden wird. \u00a0(Grade 1B)<\/li>\n<li style=\"text-align: justify;\">Wir empfehlen, dass die Gabe von FFP nicht f\u00fcr die Behandlung von Hypofibrinogen\u00e4mien genutzt wird. (Grade 1C)<\/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): Vasopressoren und Katecholamine Beim Vorliegen einer lebensbedrohlichen Hypotension [&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}},"categories":[1210],"tags":[186,1619,184],"class_list":["post-9218","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blutungsmanagement","tag-blutung","tag-ffp","tag-txa"],"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-2oG","jetpack-related-posts":[{"id":9209,"url":"https:\/\/news-papers.eu\/?p=9209","url_meta":{"origin":9218,"position":0},"title":"European bleeding guideline, 5. Auflage &#8211; Teil 2","author":"Michael Bernhard","date":"April 19, 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): Diagnostik und Monitoring\u00a0einer Blutung Wir empfehlen, dass der Arzt eine klinische Beurteilung des Blutungsausmasses anhand einer Kombination der Physiologie, anatomischen Vwerletzungszeichen, Traumamechanismus und der Patientenreaktion auf die initialen\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":9212,"url":"https:\/\/news-papers.eu\/?p=9212","url_meta":{"origin":9218,"position":1},"title":"European bleeding guideline, 5. Auflage &#8211; Teil 4","author":"Michael Bernhard","date":"Mai 1, 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): H\u00e4moglobin (Hb) Wir empfehlen einen niedrigen Hb-Wert als Marker f\u00fcr eine schwere Blutung mit assoziierter Koagulopathie heranziehen. (Grade 1B) Wir empfehlen die Nutzung von wiederholten Hb-Bestimmungen als einer\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":9202,"url":"https:\/\/news-papers.eu\/?p=9202","url_meta":{"origin":9218,"position":2},"title":"European bleeding guideline, 5. Auflage &#8211; Teil 1","author":"Michael Bernhard","date":"April 18, 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): Initiale Rettungsmassnahmen und Pr\u00e4vention weiterer Blutung Wir empfehlen, dass schwerverletzte Patienten direkt in ein geeignetes Traumazentrum transportiert werden. (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":14428,"url":"https:\/\/news-papers.eu\/?p=14428","url_meta":{"origin":9218,"position":3},"title":"Surviving Sepsis Campaign Guideline 2021 &#8211; Teil 6","author":"Michael Bernhard","date":"Oktober 18, 2021","format":false,"excerpt":"Nun zu Teil 6 der\u00a0Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). (PDF) Hier ganz\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"Sepsis","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":14524,"url":"https:\/\/news-papers.eu\/?p=14524","url_meta":{"origin":9218,"position":4},"title":"Surviving Sepsis Campaign Guideline 2021 &#8211; Teil 8","author":"Michael Bernhard","date":"Oktober 24, 2021","format":false,"excerpt":"Nun zu Teil 8\u00a0der\u00a0Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). (PDF) Hier ganz frisch\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"Sepsis","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":14412,"url":"https:\/\/news-papers.eu\/?p=14412","url_meta":{"origin":9218,"position":5},"title":"Surviving Sepsis Campaign Guideline 2021: Kernaussagen Teil 2","author":"Michael Bernhard","date":"Oktober 8, 2021","format":false,"excerpt":"Nun zu Teil 2 der\u00a0Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). (PDF) Hier ganz\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"https:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"Sepsis","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&ssl=1&resize=1050%2C600 3x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9218","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=9218"}],"version-history":[{"count":5,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9218\/revisions"}],"predecessor-version":[{"id":9355,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/9218\/revisions\/9355"}],"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=9218"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9218"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}