Abstracts/Presentation Description
Beverley J Hunt1
1Kings Healthcare Partners
Despite the increasing sophistication of our lives in high income countries, it is sobering to consider that bleeding to death -exsanguination- remains a major cause of death in the modern world. Globally 9% of all deaths are due to trauma (which ranges from blunt such as road-traffic accidents, to penetrating – knife and bullet wounds etc) of which the major cause of death in 24% is haemorrhage. Indeed, in the USA the major cause of death in pregnancy and paediatrics is gunshot wounds. One in two hundred deaths globally occur in pregnancy where once again the major cause of death is post-partum haemorrhage, with the bulk of deaths occurring in low and middle countries where there is a fragile infrastructure in medical care. Lastly there are over 500 million operations annually and one of the major causes of mortality is bleeding. What can we do as Haematologists to improve this situation?
1Kings Healthcare Partners
Despite the increasing sophistication of our lives in high income countries, it is sobering to consider that bleeding to death -exsanguination- remains a major cause of death in the modern world. Globally 9% of all deaths are due to trauma (which ranges from blunt such as road-traffic accidents, to penetrating – knife and bullet wounds etc) of which the major cause of death in 24% is haemorrhage. Indeed, in the USA the major cause of death in pregnancy and paediatrics is gunshot wounds. One in two hundred deaths globally occur in pregnancy where once again the major cause of death is post-partum haemorrhage, with the bulk of deaths occurring in low and middle countries where there is a fragile infrastructure in medical care. Lastly there are over 500 million operations annually and one of the major causes of mortality is bleeding. What can we do as Haematologists to improve this situation?
I will discuss the modern understanding of the haemostatic changes in bleeding in trauma, obstetric haemorrhage and surgical bleeding and the current guidance. The benefits of tranexamic acid in these situation will be emphasized.
References
Neal MD, Hunt BJ. Precision in Transfusion Medicine. JAMA. 2023 Nov 21;330(19):1847-1848.
Rossaint R, Afshari A, Bouillon B, Cerny V, Cimpoesu D, Curry N, Duranteau J, Filipescu D, Grottke O, Grønlykke L, Harrois A, Hunt BJ, Kaserer A, Komadina R, Madsen MH, Maegele M, Mora L, Riddez L, Romero CS, Samama CM, Vincent JL, Wiberg S, Spahn DR. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care. 2023 Mar 1;27(1):80.
Stanworth SJ, Dowling K, Curry N, Doughty H, Hunt BJ, Fraser L, Narayan S, Smith J, Sullivan I, Green L; Transfusion Task Force of the British Society for Haematology. Haematological management of major haemorrhage: a British Society for Haematology Guideline. Br J Haematol. 2022 Aug;198(4):654-667.
de Lloyd L, Jenkins PV, Bell SF, Mutch NJ, Martins Pereira JF, Badenes PM, James D, Ridgeway A, Cohen L, Roberts T, Field V, Collis RE, Collins PW. Acute obstetric coagulopathy during postpartum hemorrhage is caused by hyperfibrinolysis and dysfibrinogenemia: an observational cohort study. J Thromb Haemost. 2023 Apr;21(4):862-879.
Bell SF, de Lloyd L, Preston N, Collins PW. Managing the coagulopathy of postpartum hemorrhage: an evolving role for viscoelastic hemostatic assays. J Thromb Haemost. 2023 Aug;21(8):2064-2077. Moore EE, Moore HB, Kornblith LZ, Neal MD, Hoffman M, Mutch NJ, Schöchl H, Hunt BJ, Sauaia A. Trauma-induced coagulopathy. Nat Rev Dis Primers. 2021 Apr 29;7(1):30.
Speaker/Presenting Authors
Authors
Submitting/Presenting Authors
Prof Beverley Hunt -