Multidisciplinary consensus document on the management of massive haemorrhage. First update 2023 (document HEMOMAS-II)

Abstract

This document is an update of the multidisciplinary document HEMOMAS, published in 2016 with the endorsement of the Spanish Scientific Societies of Anaesthesiology (SEDAR), Intensive Care (SEMICYUC) and Thrombosis and Haemostasis (SETH). The aim of this document was to review and update existing recommendations on the management of massive haemorrhage. The methodology of the update was based on several elements of the ADAPTE method by searching and adapting guidelines published in the specific field of massive bleeding since 2014, plus a literature search performed in PubMed and EMBASE from January 2014 to June 2021. Based on the review of 9 guidelines and 207 selected articles, the 47 recommendations in the original article were reviewed, maintaining, deleting, or modifying each of them and the accompanying grades of recommendation and evidence. Following a consensus process, the final wording of the article and the resulting 41 recommendations were approved by all authors.

Keywords: Concentrado de hematíes; Fibrinogen; Fibrinógeno; Fresh plasma; Hemorragia masiva; Massive hemorrhage; Plasma fresco; Red blood cells; Test viscoelásticos; Transfusion; Transfusión; Viscoelastic assay.