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In our study, we define patients who need clinical intervention (ie, blood transfusion, endoscopic or surgical management for bleeding control) as high-risk patients.
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Miller and coworkers [ 44] proposed a decision-making algorithm for management of bleeding pelvic fracture.
This goal was set in response to the updated European guidelines for management of bleeding and coagulopathy [ 3].
In 2007, we published a European guideline for the management of bleeding following major trauma that included recommendations for specific interventions to identify and control bleeding sources using surgical, physiological and pharmacological strategies [ 13].
Notably, the European Guideline for the management of bleeding after major trauma has updated its recommended trigger level for fibrinogen replacement from <1 to <1.5 2.0 g litre−1.
Of these analyzed patients, 139 received PCC for the management of bleeding risk prior to surgical or invasive intervention and 686 patients for a bleeding episode.
European guidelines for the management of bleeding following major trauma were published in 2007 [4].
The last European guidelines for the management of bleeding after severe injury [11] recommended that crystalloids should be applied initially to treat the bleeding trauma patients and that the addition of colloids should be considered in hemodynamically unstable 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).
Arterial occlusion (arterial ligation or balloon tamponade) is indicated for the management of bleeding.
A general algorithm was followed for the management of bleeding depending on the severity and duration of bleeding.
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