Trauma Induced Coagulopathy
World Journal of Trauma and Critical Care Medicine 2016, 4:1
Coagulopathy is frequent present in trauma. Acute
coagulopathy associated with trauma (ACoT) has been recognized as a distinct
entity associated with increased mortality, morbidity and transfusion requirements.
Uncontrolled bleeding is the most frequent preventable cause
of death in trauma patients reaching hospital alive. Coagulopathy in trauma has
been long thought to develop as a result of hemodilution, acidosis and
hypothermia often related to resuscitation practices. The lack of well defined
diagnosis criteria for ACoT impedes early identification and treatment.
Prolongation of prothrombin time (PT) and activated thromboplastine time (APTT)
have been used by most author to diagnosis ACoT. Mechanisms contributing to
ACoT include anticoagulation, consumption, platelet dysfunction and
hyperfibrinolysis. Early administration of tranexamic acid ,recombinant factor Ⅶ and
aggressive blood product transfusional management for ACoT with a red blood
cell: plasma: platelets ratio close to 1:1:1 could result in decreased
mortality from uncontrolled bleeding. This article will review the
pathophysiology and management of ACoT.
Acute coagulopathy associated with trauma
(ACoT); tranexamic acid; recombinant factor VII