Uncontrolled bleeding accounts for a significant proportion of early traumatic deaths,
and almost always occur within the first six hours of injury. In previous randomised
controlled trials (RCTs) of transfusion for injured patients with major bleeding the
median time to haemorrhagic death, in trauma systems with rapid transport from injury
to hospital was 2-2.6 hours from admission [
[1]
]. Acute Traumatic Coagulopathy (ATC) occurs within minutes of injury and is evident
prior to the arrival of patients in hospital [
[2]
]. Non-blood component transfusions e.g. crystalloid, do not enable oxygen delivery
to the tissues, produce haemodilution of circulating clotting factors, are non-haemostatic,
and are harmful to the endothelium. Balanced resuscitation, so called damage control
resuscitation which priorities red blood cells with plasma based products has been
shown to have restorative effects on the endothelium, ameliorate ATC and improve survival.To read this article in full you will need to make a payment
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https://www.nhsbt.nhs.uk/clinical-trials-unit/current-trials-and-studies/swift/.
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