SEVERE injuries are the leading cause of death in
\nthe world population below 45 years of age (1).
\nExsanguination is a major factor contributing to
\nmortality in these patients. Thus, haemorrhage
\ncontrol and volume resuscitation have high priority
\nin Advanced Trauma Life Support (ATLS)
\nprinciples. The rationale during acute treatment is
\nthe maintenance of oxygen delivery and adequate
\ntissue oxygenation. Early resuscitation after haemorrhagic
\nshock, according to ATLS, comprises 2 l
\nof crystalloid solution, followed by packed RBC
\ntransfusion to maintain haemoglobin between 7
\nand 9 g\/dl (2).
\nOnce resuscitated and monitored in the intensive
\ncare unit (ICU), trauma patients receive repeatedly
\npacked RBC transfusions to induce an increase in
\nthe haemoglobin concentration often even days
\nafter the initial trauma. Corwin et al. (3) reported
\nthat more than 44% of all patients (n5284) in the
\nICU needed red blood cell (RBC) concentrates, with
\na mean of 4.6 units. Livingston et al. (4) reported
\nthat more than 80% of the trauma patients in the
\nICU received weekly blood transfusions, while
\nonly 35% of transfusions are related to an acute
\nblood loss (5). It is apparent that the need for
\nblood transfusions is prolonged and extends to
\neven long after the initial injury. In these patients,
\nhaemorrhage is only one cause of persistent anaemia.
\nTriggered by systemic inflammation after
\nmultiple trauma bone marrow dysfunction due to
\na blunted erythropoietin (EPO) response, reduced
\niron availability and loss of erythroid progenitors
\nthrough apoptosis and egress seem to cause
\nchronic anaemia similar to anaemia of chronic
\ndisease (6).<\/div>\n","protected":false},"excerpt":{"rendered":"

Editorial: Acta Anaesthesiol Sc Fecha: 01\/05\/2008 Robinson Y Acceso al enlace publicador SEVERE injuries are the leading cause of death<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[4],"tags":[],"_links":{"self":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/269"}],"collection":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/comments?post=269"}],"version-history":[{"count":1,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/269\/revisions"}],"predecessor-version":[{"id":755,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/posts\/269\/revisions\/755"}],"wp:attachment":[{"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/media?parent=269"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/categories?post=269"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/awge.doctime.es\/index.php\/wp-json\/wp\/v2\/tags?post=269"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}