创伤性出血性休克
原作者： Michael Winters，肖锋译 文章来源： 中华急诊医学杂志编辑部 发布日期：2013-03-04

Title: Traumatic Hemorrhage Shock
题目：创伤性出血性休克
Author 作者: Michael Winters

When managing the critically ill patient with traumatic hemorrhagic shock, the primary objectives are to stop bleeding, maintain tissue perfusion and oxygen delivery, and limit organ dysfunction.
在处理创伤性出血性休克危重病人时，主要的目的是止血，维持组织灌注和氧供，及减少器官损伤
Pearls to consider when resuscitating these patients include:
对于这样病人的复苏的精髓包括：
In the patient without brain injury, target an SBP of 80 - 100 mm Hg until major bleeding has been controlled.
对没有脑损伤的病人，在大出血没有控制前，要维持收缩压在80－100mmHg
Limit aggressive fluid resuscitation
限制大量的输液
Avoid delays in blood and blood component transfusion. 
Transfuse early. Though the optimal ratio remains controversial, most transfuse PRBCs and FFP in a 1:1 ratio.
不要延误输血或血液成分，尽快输血！虽然还没有明确的比例，全血和冻干血浆的比例应该在1：1
Consider point-of-care testing, such as thromboelastography (TEG), to assess the degree of coagulopathy and guide transfusion strategies.
考虑床旁检测，如血栓弹力图确定凝血病的程度并指导输血计划
Consider the use of tranexamic acid
考虑用胺甲环酸

References参考文献
Bougle A, et al. Resuscitative strategies in traumatic hemorrhagic shock. Annals of Intensive Care 2013; 3.