Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology
Purpose Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results Restrictive volume...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2020-03-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2020-015.pdf |
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| author | Pil Young Jung Byungchul Yu Chan-Yong Park Sung Wook Chang O Hyun Kim Maru Kim Junsik Kwon Gil Jae Lee Korean Society of Traumatology (KST) Clinical Research Group |
| author_facet | Pil Young Jung Byungchul Yu Chan-Yong Park Sung Wook Chang O Hyun Kim Maru Kim Junsik Kwon Gil Jae Lee Korean Society of Traumatology (KST) Clinical Research Group |
| author_sort | Pil Young Jung |
| collection | DOAJ |
| description | Purpose Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80–90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100–110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient’s initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years. |
| format | Article |
| id | doaj-art-df594d91b90e4d4e8316bd0ef70cdcd3 |
| institution | Kabale University |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-df594d91b90e4d4e8316bd0ef70cdcd32025-01-08T08:08:18ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832020-03-0133111210.20408/jti.2020.0151002Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of TraumatologyPil Young Jung0Byungchul Yu1Chan-Yong Park2Sung Wook Chang3O Hyun Kim4Maru Kim5Junsik Kwon6Gil Jae Lee7Korean Society of Traumatology (KST) Clinical Research Group Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Traumatology, Gachon University College of Medicine, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea Department of Trauma Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea Department of Traumatology, Gachon University College of Medicine, Gachon University Gil Medical Center, Incheon, KoreaPurpose Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80–90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100–110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient’s initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.http://www.jtraumainj.org/upload/pdf/jti-2020-015.pdfshock, traumaticpractice guidelinewounds and injuries |
| spellingShingle | Pil Young Jung Byungchul Yu Chan-Yong Park Sung Wook Chang O Hyun Kim Maru Kim Junsik Kwon Gil Jae Lee Korean Society of Traumatology (KST) Clinical Research Group Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology Journal of Trauma and Injury shock, traumatic practice guideline wounds and injuries |
| title | Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology |
| title_full | Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology |
| title_fullStr | Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology |
| title_full_unstemmed | Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology |
| title_short | Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology |
| title_sort | clinical practice guideline for the treatment of traumatic shock patients from the korean society of traumatology |
| topic | shock, traumatic practice guideline wounds and injuries |
| url | http://www.jtraumainj.org/upload/pdf/jti-2020-015.pdf |
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