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Patients with bleeding had a higher risk of in-hospital death (HR 2.09, 1.69-2.57).As major bleeding has modifiable risk factors and is associated with in-hospital mortality, strategies to mitigate these factors should be evaluated in critically ill patients.
However, European guidelines for the management of bleeding trauma patients recommended a target systolic blood pressure of 80 to 100 mmHg until major bleeding has been stopped in the initial phase after trauma for patients without brain injury [11] (Figure 1).
The authors recommend a target systolic blood pressure of 80 to 100 mmHg until major bleeding has been stopped in the initial phase following trauma without brain injury.
We recommend a target systolic blood pressure of 80to9090 mmHg until major bleeding has been stopped in the initial phase following trauma without brain injury.
We recommend a target systolic blood pressure of 80 to 100 mmHg until major bleeding has been stopped in the initial phase following trauma without brain injury (Grade 1C).
We suggest a target systolic blood pressure of 80 to 100 mm Hg until major bleeding has been stopped in the initial phase following trauma without brain injury (grade 2C).
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aNo patient with major bleeding had this putative risk factor.
(Grade 2C) rFVIIa is not a first-line treatment for bleeding and can be effective only once sources of major bleeding have been controlled.
rFVIIa is not a first-line treatment for bleeding and will be effective only once sources of major bleeding have been controlled.
In the ACUITY trial, patients with NSTE ACS who experienced major bleeding had significantly higher 30-day incidences of death, composite ischemia and stent thrombosis than patients without major bleeding (p < 0.0001 for all 3 outcomes), and major bleeding was the strongest independent predictor of 30-day mortality (HR: 7.55; 95% CI 4.68 12.18; p < 0.0001) [ 63].
In spite of the limited time of observation (60 days) versus the very long half-life (100-360 h) of vorapaxar, no difference in the primary end-point of major or minor bleeding has been found (2%, 3%, 4% in the three loading dose groups versus 3.3% in placebo group P= 0.57).
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