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Exsanguination

MedGen UID:
68550
•Concept ID:
C0232100
•
Pathologic Function
Synonyms: Exsanguinating Hemorrhage; Exsanguinating Hemorrhages; Hemorrhage, Exsanguinating; Hemorrhages, Exsanguinating
SNOMED CT: Exsanguination (48149007); Total blood loss (48149007)

Definition

Extensive loss of blood due to internal or external hemorrhage. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVExsanguination

Professional guidelines

PubMed

Management of Pelvic Trauma.
Baker JE, Werner NL, Burlew CC
Surg Clin North Am 2024 Apr;104(2):367-384. Epub 2023 Nov 22 doi: 10.1016/j.suc.2023.10.001. PMID: 38453308
Diagnosis and Management of Traumatic Hemipelvectomy.
Patch DA, Hess MC, Spitler CA, Johnson JP
J Am Acad Orthop Surg 2022 Sep 15;30(18):888-895. Epub 2022 May 24 doi: 10.5435/JAAOS-D-21-01018. PMID: 36166384
The systemic immune response to trauma: an overview of pathophysiology and treatment.
Lord JM, Midwinter MJ, Chen YF, Belli A, Brohi K, Kovacs EJ, Koenderman L, Kubes P, Lilford RJ
Lancet 2014 Oct 18;384(9952):1455-65. Epub 2014 Oct 17 doi: 10.1016/S0140-6736(14)60687-5. PMID: 25390327Free PMC Article

Recent clinical studies

Etiology

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.
Jansen JO, Hudson J, Cochran C, MacLennan G, Lendrum R, Sadek S, Gillies K, Cotton S, Kennedy C, Boyers D, Ferry G, Lawrie L, Nath M, Wileman S, Forrest M, Brohi K, Harris T, Lecky F, Moran C, Morrison JJ, Norrie J, Paterson A, Tai N, Welch N, Campbell MK; UK-REBOA Study Group, Aylwin C, Bew D, Brooks A, Chinery J, Cowlam T, Frith D, George A, Hudson A, Johnstone P, Mahmood A, Novak A, O'Meara M, Reid S, Sattout A, Smith C, Stansfield T, Thompson J
JAMA 2023 Nov 21;330(19):1862-1871. doi: 10.1001/jama.2023.20850. PMID: 37824132Free PMC Article
Vasa Previa.
Oyelese Y, Javinani A, Shamshirsaz AA
Obstet Gynecol 2023 Sep 1;142(3):503-518. Epub 2023 Aug 3 doi: 10.1097/AOG.0000000000005287. PMID: 37590981Free PMC Article
Epistaxis and mortality.
Integrate (The National ENT Trainee Research Network)
J Laryngol Otol 2018 Dec;132(12):1061-1066. Epub 2018 Nov 20 doi: 10.1017/S0022215118002013. PMID: 30457066
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group
JAMA 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203Free PMC Article
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, Cook L, Kawahara T, Perel P, Prieto-Merino D, Ramos M, Cairns J, Guerriero C
Health Technol Assess 2013 Mar;17(10):1-79. doi: 10.3310/hta17100. PMID: 23477634Free PMC Article

Diagnosis

Vasa Previa.
Oyelese Y, Javinani A, Shamshirsaz AA
Obstet Gynecol 2023 Sep 1;142(3):503-518. Epub 2023 Aug 3 doi: 10.1097/AOG.0000000000005287. PMID: 37590981Free PMC Article
Severe Trauma-Induced Coagulopathy: Molecular Mechanisms Underlying Critical Illness.
Zanza C, Romenskaya T, Racca F, Rocca E, Piccolella F, Piccioni A, Saviano A, Formenti-Ujlaki G, Savioli G, Franceschi F, Longhitano Y
Int J Mol Sci 2023 Apr 12;24(8) doi: 10.3390/ijms24087118. PMID: 37108280Free PMC Article
Thoracic outlet syndrome: a review.
Panther EJ, Reintgen CD, Cueto RJ, Hao KA, Chim H, King JJ
J Shoulder Elbow Surg 2022 Nov;31(11):e545-e561. Epub 2022 Aug 10 doi: 10.1016/j.jse.2022.06.026. PMID: 35963513
Life-Threatening Hemoptysis.
Deshwal H, Sinha A, Mehta AC
Semin Respir Crit Care Med 2021 Feb;42(1):145-159. Epub 2020 Aug 30 doi: 10.1055/s-0040-1714386. PMID: 32862418
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, Cook L, Kawahara T, Perel P, Prieto-Merino D, Ramos M, Cairns J, Guerriero C
Health Technol Assess 2013 Mar;17(10):1-79. doi: 10.3310/hta17100. PMID: 23477634Free PMC Article

Therapy

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.
Jansen JO, Hudson J, Cochran C, MacLennan G, Lendrum R, Sadek S, Gillies K, Cotton S, Kennedy C, Boyers D, Ferry G, Lawrie L, Nath M, Wileman S, Forrest M, Brohi K, Harris T, Lecky F, Moran C, Morrison JJ, Norrie J, Paterson A, Tai N, Welch N, Campbell MK; UK-REBOA Study Group, Aylwin C, Bew D, Brooks A, Chinery J, Cowlam T, Frith D, George A, Hudson A, Johnstone P, Mahmood A, Novak A, O'Meara M, Reid S, Sattout A, Smith C, Stansfield T, Thompson J
JAMA 2023 Nov 21;330(19):1862-1871. doi: 10.1001/jama.2023.20850. PMID: 37824132Free PMC Article
Vasa Previa.
Oyelese Y, Javinani A, Shamshirsaz AA
Obstet Gynecol 2023 Sep 1;142(3):503-518. Epub 2023 Aug 3 doi: 10.1097/AOG.0000000000005287. PMID: 37590981Free PMC Article
Hematopoietic stem cells under pressure.
Ganuza M, McKinney-Freeman S
Curr Opin Hematol 2017 Jul;24(4):314-321. doi: 10.1097/MOH.0000000000000347. PMID: 28375987Free PMC Article
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group
JAMA 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203Free PMC Article
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, Cook L, Kawahara T, Perel P, Prieto-Merino D, Ramos M, Cairns J, Guerriero C
Health Technol Assess 2013 Mar;17(10):1-79. doi: 10.3310/hta17100. PMID: 23477634Free PMC Article

Prognosis

The emerging therapeutic potential of extracellular vesicles in trauma.
Alsaadi N, Srinivasan AJ, Seshadri A, Shiel M, Neal MD, Scott MJ
J Leukoc Biol 2022 Jan;111(1):93-111. Epub 2021 Sep 17 doi: 10.1002/JLB.3MIR0621-298R. PMID: 34533241Free PMC Article
Epistaxis and mortality.
Integrate (The National ENT Trainee Research Network)
J Laryngol Otol 2018 Dec;132(12):1061-1066. Epub 2018 Nov 20 doi: 10.1017/S0022215118002013. PMID: 30457066
Fresh Whole Blood Transfusion: Military and Civilian Implications.
Goforth CW, Tranberg JW, Boyer P, Silvestri PJ
Crit Care Nurse 2016 Jun;36(3):50-7. doi: 10.4037/ccn2016780. PMID: 27252101
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group
JAMA 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203Free PMC Article
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, Cook L, Kawahara T, Perel P, Prieto-Merino D, Ramos M, Cairns J, Guerriero C
Health Technol Assess 2013 Mar;17(10):1-79. doi: 10.3310/hta17100. PMID: 23477634Free PMC Article

Clinical prediction guides

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.
Jansen JO, Hudson J, Cochran C, MacLennan G, Lendrum R, Sadek S, Gillies K, Cotton S, Kennedy C, Boyers D, Ferry G, Lawrie L, Nath M, Wileman S, Forrest M, Brohi K, Harris T, Lecky F, Moran C, Morrison JJ, Norrie J, Paterson A, Tai N, Welch N, Campbell MK; UK-REBOA Study Group, Aylwin C, Bew D, Brooks A, Chinery J, Cowlam T, Frith D, George A, Hudson A, Johnstone P, Mahmood A, Novak A, O'Meara M, Reid S, Sattout A, Smith C, Stansfield T, Thompson J
JAMA 2023 Nov 21;330(19):1862-1871. doi: 10.1001/jama.2023.20850. PMID: 37824132Free PMC Article
Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality.
Sperry JL, Cotton BA, Luther JF, Cannon JW, Schreiber MA, Moore EE, Namias N, Minei JP, Wisniewski SR, Guyette FX; Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group
J Am Coll Surg 2023 Aug 1;237(2):206-219. Epub 2023 Apr 11 doi: 10.1097/XCS.0000000000000708. PMID: 37039365Free PMC Article
Epistaxis and mortality.
Integrate (The National ENT Trainee Research Network)
J Laryngol Otol 2018 Dec;132(12):1061-1066. Epub 2018 Nov 20 doi: 10.1017/S0022215118002013. PMID: 30457066
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group
JAMA 2015 Feb 3;313(5):471-82. doi: 10.1001/jama.2015.12. PMID: 25647203Free PMC Article
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, Cook L, Kawahara T, Perel P, Prieto-Merino D, Ramos M, Cairns J, Guerriero C
Health Technol Assess 2013 Mar;17(10):1-79. doi: 10.3310/hta17100. PMID: 23477634Free PMC Article

Recent systematic reviews

Impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) in traumatic abdominal and pelvic exsanguination: a systematic review and meta-analysis.
Granieri S, Frassini S, Cimbanassi S, Bonomi A, Paleino S, Lomaglio L, Chierici A, Bruno F, Biondi R, Di Saverio S, Khan M, Cotsoglou C
Eur J Trauma Emerg Surg 2022 Oct;48(5):3561-3574. Epub 2022 Mar 20 doi: 10.1007/s00068-022-01955-6. PMID: 35307763
A systematic review and meta-analysis of the use of resuscitative endovascular balloon occlusion of the aorta in the management of major exsanguination.
Borger van der Burg BLS, van Dongen TTCF, Morrison JJ, Hedeman Joosten PPA, DuBose JJ, Hörer TM, Hoencamp R
Eur J Trauma Emerg Surg 2018 Aug;44(4):535-550. Epub 2018 May 21 doi: 10.1007/s00068-018-0959-y. PMID: 29785654Free PMC Article
Animal experimentation in forensic sciences: How far have we come?
Cattaneo C, Maderna E, Rendinelli A, Gibelli D
Forensic Sci Int 2015 Sep;254:e29-35. Epub 2015 Jul 15 doi: 10.1016/j.forsciint.2015.06.024. PMID: 26216717
Venous injuries in pediatric trauma: Systematic review of injuries and management.
Rowland SP, Dharmarajah B, Moore HM, Dharmarajah K, Davies AH
J Trauma Acute Care Surg 2014 Aug;77(2):356-63. doi: 10.1097/TA.0000000000000312. PMID: 25058265
Pre-hospital haemostatic dressings: a systematic review.
Granville-Chapman J, Jacobs N, Midwinter MJ
Injury 2011 May;42(5):447-59. doi: 10.1016/j.injury.2010.09.037. PMID: 21035118

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