Transfusion products and blood derivatives in light of new European guidelines for severe bleeding

Czech version

Authors: K. Vrbica ¹; K. Vaníčková ¹; T. Prokopová ^1,2; F. Keller ¹; J. Hudec ^1,2; O. Hrdý ¹; J. Jendrichovský ¹; R. Gál ¹
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny LF MU a FN Brno ¹; Ústav simulační medicíny, LF MU, Brno ²
Published in: Transfuze Hematol. dnes,30, 2024, No. 4, p. 235-241.
Category: Review/Educational Papers
doi: https://doi.org/10.48095/cctahd2024prolekare.cz18

Overview

Major bleeding is one of the most serious emergencies in medicine. This situation requires a complex therapeutic approach, including standardised administering transfusion products and blood derivatives. In the Czech Republic and Slovakia, the document “Diagnosis and Treatment of Life-Threatening Bleeding in Adult Patients in Intensive and Perioperative Care. Czech-Slovak Interdisciplinary Guideline” from 2017 remains valid. In 2023, an update of both European guidelines, from which the mentioned interdisciplinary procedure predominantly derives, was published. This work aims to identify and present changes in the European guidelines for severe bleeding since 2017. A total of 4 texts are included. Their analysis was divided according to individual transfusion products and blood derivatives. This work not only presents the new European guidelines for treating severe bleeding, but also compares these with the Czech-Slovak guideline from 2017.

Keywords:

Blood transfusion – bleeding – guidelines – blood coagulation factors

Sources

1. Curry N, Hopewell S, Dorée C, Hyde C, Brohi K, Stanworth S. The acute management of trauma hemorrhage: a systematic review of randomized controlled trials. Crit Care. 2011; 15 (2): R92.

2. Ghadimi K, Levy JH, Welsby IJ. Perioperative management of the bleeding patient. Brit J Anaesth. 2016; 117 (Suppl 3): iii18.

3. Blatný J, Bláha J, Cvachovec K, et al. Diagnostika a léčba život ohrožujícího krvácení u dospělých pacientů v intenzivní a perioperační péči. Česko-slovenský mezioborový doporučený postup. Anestez Intenziv Med. 2017; 28 (4): 263–269.

4. Rossaint R, Afshari A, Bouillon B, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care. 2023; 27 (1): 1–45.

5. Kietaibl S, Ahmed A, Afshari A, et al. Management of severe peri-operative bleeding: guidelines from the European Society of Anaesthesiology and Intensive Care: Second update 2022. Eur J Anaesthesiol. 2023; 40 (4): 226–304.

6. Vlaar APJ, Dionne JC, de Bruin S, et al. Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intens Care Med. 2021; 47 (12): 1368–1392.

7. Rossaint R, Bouillon B, Cerny V, et al. The European guidelines on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care. 2016; 20 (1): 1–55.

8. Kozek-Langenecker SA, Afshari A, Albaladejo P, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2013; 30 (6): 270–382.

9. Grottke O, Mallaiah S, Karkouti K, Saner F, Haas T. Fibrinogen supplementation and its indications. Semin Thromb Hemost. 2020; 46 (1): 38–49.

10. Litvinov RI, Weisel JW. Role of red blood cells in haemostasis and thrombosis. ISBT Sci Ser. 2017; 12 (1): 176–183.

11. Green L, Stanworth S, McQuilten Z et al. International forum on the management of major haemorrhage: summary. Vox Sang. 2022; 117 (5): 746–753.

12. Florez-Perdomo WA, García-Ballestas E, Martinez-Perez R, et al. Hemoglobin levels as a transfusion criterion in moderate to severe traumatic brain injury: a systematic review and meta-analysis. Br J Neurosurg. 2021; 37 (6): 1473–1479.

13. Delaney M, Stark PC, Suh M, et al. Massive transfusion in cardiac surgery: the impact of blood component ratios on clinical outcomes and survival. Anesth Analg. 2017; 124 (6): 1777–82.

14. Mazzeffi MA, Chriss E, Davis K, et al. Optimal plasma transfusion in patients undergoing cardiac operations with massive transfusion. Ann Thorac Surg. 2017; 104 (1): 153–160.

15. Tsukinaga A, Maeda T, Takaki S, Michihata N, Ohnishi Y, Goto T. Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery. J Anesth. 2018; 32 (4): 539–546.

16. Levy JH, Grottke O, Fries D, Kozek-Langenecker S. Therapeutic plasma transfusion in bleeding patients: A systematic review. Anesth Analg. 2017; 124 (4): 1268–1276.

17. Innerhofer P, Fries D, Mittermayr M, et al. Reversal of trauma-induced coagulopathy using first-line coagulation factor concentrates or fresh frozen plasma (RETIC): a single-centre, parallel-group, open-label, randomised trial. Lancet Haematol. 2017; 4 (6): e258–e271.

18. Rock G. A comparison of methods of pathogen inactivation of FFP. Vox Sang. 2011; 100 (2): 169–178.

19. Sang Y, Roest M, de Laat B, de Groot PG, Huskens D. Interplay between platelets and coagulation. Blood Rev. 2021; 46 : 100733.

20. Penka M, Penka I, Gumulec J. Krvácení. 1. vyd. Praha, Grada, 2014.

21. McCormack PL. Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. Drugs. 2012; 72 (5): 585–617.

22. van den Brink DP, Wirtz MR, Neto AS, et al. Effectiveness of prothrombin complex concentrate for the treatment of bleeding: A systematic review and meta-analysis. J Thromb Haemost. 2020; 18 (10): 2457–2467.

23. Sørensen B, Spahn DR, Innerhofer P, Spannagl M, Rossaint R. Clinical review: prothrombin complex concentrates –⁠ evaluation of safety and thrombogenicity. Crit Care. 2011; 15 : 201.

24. Ghadimi K, Levy JH, Welsby IJ. Prothrombin complex concentrates for bleeding in the perioperative setting. Anesth Analg. 2016; 122 (5): 1287–1300.

25. Neufeld EJ, Négrier C, Arkhammar P, et al. Safety update on the use of recombinant activated factor VII in approved indications. Blood Rev. 2015; 29 Suppl 1 (S1): S34–S41.

26. Sim DS, Mallari CR, Hermiston TW, et al. CT-001, a novel fast-clearing factor VIIa, enhanced the hemostatic activity in postpartum samples. Blood Adv. 2024; 8 (2): 287.

27. Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C. Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia. Cochrane Database Syst Rev. 2012. DOI: 10.1002/14651858.CD005011.pub4

28. Lombardo S, Millar D, Jurkovich GJ, Coimbra R, Nirula R. Factor VIIa administration in traumatic brain injury: an AAST-MITC propensity score analysis. Trauma Surg Acute Care Open. 2018; 3 (1): e000134. DOI: 10.1136/tsaco-2017-000134.

29. Deloughery EP, Lenfesty B, Deloughery TG. The use of recombinant factor VIIa in warfarin patients with traumatic brain injury: a retrospective case-control study. Blood Coagul Fibrinolysis. 2013; 24 (3): 317–320.

30. Bagoly Z, Koncz Z, Hársfalvi J, Muszbek L. Factor XIII, clot structure, thrombosis. Thromb Res. 2012; 129 (3): 382–387.

31. Stein P, Kaserer A, Sprengel K, et al. Change of transfusion and treatment paradigm in major trauma patients. Anaesthesia. 2017; 72 (11): 1317–1326.

PODÍL AUTORŮ NA PŘÍPRAVĚ RUKOPISU

KVr –⁠ koncept publikace, rešeršní činnost, psaní manuskriptu, finální editorství

TP, JH –⁠ koncept publikace, psaní manuskriptu, finální editorství

KVa –⁠ koncept publikace, psaní manuskriptu, finální editorství

FK, OH, JJ –⁠ psaní manuskriptu

RG –⁠ finální editorství.

PROHLÁŠENÍ O STŘETU ZÁJMŮ

K. Vrbica a R. Gál prohlašují, že v souvislosti s tématem článku v uplynulých 24 měsících obdrželi honorář za přednáškovou a/nebo konzultační činnost pro firmu CSL Behring.

K. Vaníčková prohlašuje, že v uplynulých 24 měsících obdržela honorář za přednáškovou a/nebo konzultační činnost pro firmu CSL Behring a Octapharma.

T. Prokopová, F. Keller, J. Hudec, O. Hrdý a J. Jendrichovský prohlašují, že v souvislosti s tématem, vznikem a publikací tohoto článku nejsou ve střetu zájmů a vznik ani publikace článku nebyly podpořeny žádnou farmaceutickou firmou.

FINANCOVÁNÍ

Tento projekt vznikl za podpory Specifického výzkumu LF MU (MUNI/A/1600/2023) a MZ ČR –⁠ RVO (FNBr 65269705).

Do redakce doručeno dne: 3. 7. 2024.

Přijato po recenzi: 17. 10. 2024.

MUDr. Kateřina Vaníčková

Klinika anesteziologie,

resuscitace a intenzivní medicíny

FN Brno

Jihlavská 20

625 00 Brno

e-mail: vanickova.katerina@fnbrno.cz