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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
#37: Diagnosis and management of vasa previa.
Society of Maternal-Fetal (SMFM) Publications Committee, Sinkey RG, Odibo AO, Dashe JS
Am J Obstet Gynecol 2015 Nov;213(5):615-9. Epub 2015 Aug 18 doi: 10.1016/j.ajog.2015.08.031. PMID: 26292048
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
#37: Diagnosis and management of vasa previa.
Society of Maternal-Fetal (SMFM) Publications Committee, Sinkey RG, Odibo AO, Dashe JS
Am J Obstet Gynecol 2015 Nov;213(5):615-9. Epub 2015 Aug 18 doi: 10.1016/j.ajog.2015.08.031. PMID: 26292048
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

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
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
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
#37: Diagnosis and management of vasa previa.
Society of Maternal-Fetal (SMFM) Publications Committee, Sinkey RG, Odibo AO, Dashe JS
Am J Obstet Gynecol 2015 Nov;213(5):615-9. Epub 2015 Aug 18 doi: 10.1016/j.ajog.2015.08.031. PMID: 26292048
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
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
Placenta previa, placenta accreta, and vasa previa.
Oyelese Y, Smulian JC
Obstet Gynecol 2006 Apr;107(4):927-41. doi: 10.1097/01.AOG.0000207559.15715.98. PMID: 16582134

Prognosis

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
Placenta previa, placenta accreta, and vasa previa.
Oyelese Y, Smulian JC
Obstet Gynecol 2006 Apr;107(4):927-41. doi: 10.1097/01.AOG.0000207559.15715.98. PMID: 16582134
Abdominal aortic aneurysms.
Fortner G, Johansen K
West J Med 1984 Jan;140(1):50-9. PMID: 6702193Free 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
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
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

Tourniquet use for civilian extremity hemorrhage: systematic review of the literature.
BenÍtez CY, Ottolino P, Pereira BM, Lima DS, Guemes A, Khan M, Ribeiro Junior MAF
Rev Col Bras Cir 2021;48:e20202783. Epub 2021 Jan 13 doi: 10.1590/0100-6991e-20202783. PMID: 33470370Free PMC Article
The safety and efficacy of improvised tourniquets in life-threatening hemorrhage: a systematic review.
Cornelissen MP, Brandwijk A, Schoonmade L, Giannakopoulos G, van Oostendorp S, Geeraedts L Jr
Eur J Trauma Emerg Surg 2020 Jun;46(3):531-538. Epub 2019 Aug 20 doi: 10.1007/s00068-019-01202-5. PMID: 31432195
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

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