ABSTRACTS
Prehospital Interventions That Improve Survival in Trauma Resuscitation: A Literature Review and Meta-AnalysisAuthor: Juan David Ricardo Escobar Espinosa | | Associate Authors: Ornella Arcieri Meza, MD, Álvaro Granados Rodríguez, Gina Marcela Murcia Chaves
Introduction Major bleeding is one of the most frequent causes of death secondary to trauma due to decreased perfusion of vital organs and tissue oxygenation. It is a main cause of preventable mortality. The management of major bleeding has been modified, but many of the changes are still subject to debate. Objective To synthesize the most recent evidence on clinical practices that improve survival of patients with major trauma during their initial care and CPR from January 2000 to January 2020. Methods A systematic review and meta-analysis were performed based on randomized clinical trials, systematic reviews, and observational studies on clinical practices and resuscitation maneuvers in databases such as Pubmed, Cochrane, Lilacs, and VHL in French, Portuguese, English, German, and Spanish. A total of 33 articles (1–33) were chosen. Of those, 39.4% were randomized clinical trials (1, 3, 7, 11, 13, 19–21, 23, 29, 30, 33) and meta-analyses (10, 12, 14–18, 22, 28, 31), respectively; 15.2% were observational studies (2, 5, 6, 8, 9, 24, 26, 27); and 3.03% were a cohort study (4) and systematic reviews (24), respectively. Results: Conclusions Tranexamic acid, hypotensive resuscitation, hypothermia, hypertonic solutions, and whole blood in trauma patients promote survival and decrease mortality, but types of trauma and effects of trauma must be considered to achieve such benefits. Men between 30 and 40 years have a higher rate of affectation in trauma, but without differences in the benefits of therapeutic strategies by age or sex.
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