Clinical Insights: Critical Bleeding in Different Clinical Scenarios (Volume II)

Critical bleeding remains one of the most time-sensitive and high-stakes conditions in modern medicine. Whether occurring in trauma, major surgery, obstetrics, gastrointestinal emergencies, or in patients treated with anticoagulant therapy, severe hemorrhage demands rapid decision-making under conditions of profound physiological instability.While damage control resuscitation and targeted hemostatic therapy have advanced significantly, substantial knowledge gaps persist. The complex interaction between endothelial dysfunction, inflammation, platelet impairment, fibrinolysis, and pharmacologic anticoagulation challenges traditional transfusion paradigms. Precision-based approaches to hemostatic resuscitation are emerging, yet the optimal integration of ratio-based transfusion, coagulation factor concentrates, antifibrinolytics, and specific reversal agents remains incompletely defined.The rising prevalence of anticoagulant and antithrombotic therapy has transformed the landscape of emergency bleeding management. Clinicians must navigate urgent reversal strategies, thrombotic risk, laboratory interpretation, and evolving antidote availability—often with limited high-quality comparative evidence. Generating robust data in this area is an urgent priority.Moreover, inconsistencies in defining massive transfusion, variable laboratory thresholds (including differences among VHA platforms), and insufficient reporting of intervention timing continue to limit the generalizability of clinical trials. Greater methodological standardization and integration of mechanistic insights with outcome-based research are critically needed.This Research Topic is a second volume of a previous collection (see here) that seeks high-quality contributions that:· Advance understanding of the mechanistic pathways driving coagulopathy across diverse bleeding states, including anticoagulant-associated hemorrhage.· Refine definitions and prognostic markers of massive and clinically relevant bleeding to enhance research comparability and clinical translation.· Evaluate and compare hemostatic resuscitation strategies, including VHA-guided algorithms, factor concentrate–based therapy, transfusion ratios, antifibrinolytics, and anticoagulant reversal agents.· Provide innovative clinical data, translational research, real-world audits, and system-level perspectives that may influence future guidelines and practice.We particularly encourage submissions that integrate pathophysiology with clinical outcomes, apply rigorous methodology, or challenge existing paradigms in the management of critical bleeding.Original research, systematic reviews, multicenter studies, registry analyses, case series, expert perspectives, and translational investigations are highly encouraged. Topic editors: Krisztian Tanczos, Diana Schrick, Gabor Nardai Source: https://www.frontiersin.org/research-topics/78711/clinical-insights-critical-bleeding-in-different-clinical-scenarios-volume-ii