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Master Thesis

Prise en charge des chocs hémorragiques et place de la transfusion de concentrés de globules rouges en médecine pré-hospitalière : analyse des pratiques au SMUR du CHU de Bordeaux

Abstract : Introduction: The management of hemorrhagic shock in pre-hospital care remains heterogeneous, despite regularly updated recommendations. On the other hand, many studies raise the question of the relevance of pre-hospital packed red blood cells (PRBC) transfusion, and its indications. The main objective of this study is to analyze the practices within mobile intensive care unit (MICU) teams of the Bordeaux teaching hospital, on the management of hemorrhagic shock when patients were transfused. Materials and methods: We conducted a retrospective descriptive observational study. During the period January to December 2015, consecutive patients in whom the diagnosis of hemorrhagic shock was conducted, who received transfusion of at least one PRBC were included. We analyzed clinical settings, and terms of the management, by performing subgroup analysis according to initial severity. Results: Over a period of one year, 48 patients were enrolled. The average age of patients was 55 years old and etiology most frequently found was upper gastrointestinal bleeding care at home. The analysis of the management revealed that at the end of emergency response the patient lost 1,5 g/dL of hemoglobin, the median number of PRBC transfused was 2 [2–3] without being guided by the initial severity. On the other hand, the median final systolic blood pressure (SBP) was 110 mmHg [86,75–120]. Conclusion: The assessments of professional practice identified areas of improvement on the pre-hospital management of hemorrhagic shock. The multidisciplinary writing of a protocol is required. A study comparing patients transfused to those not transfused would provide additional arguments about the place of pre-hospital PRBC transfusion.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01415063
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, December 12, 2016 - 5:50:48 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:19 PM
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Stephen Alamo. Prise en charge des chocs hémorragiques et place de la transfusion de concentrés de globules rouges en médecine pré-hospitalière : analyse des pratiques au SMUR du CHU de Bordeaux. Médecine humaine et pathologie. 2016. ⟨dumas-01415063⟩

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