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Coagulation in trauma

Publication ,  Journal Article
Theusinger, OM; Baulig, W; Levy, JH
Published in: Trends in Anaesthesia and Critical Care
February 1, 2015

Uncontrollable bleeding is the major cause of possible preventable death after traumatic injury. Up to one third of patients admitted to the emergency room will develop the so-called trauma induced coagulopathy (TIC) which has been shown to be associated with massive transfusions, increased morbidity and mortality. Several recent studies contribute to our present understanding of the pathophysiological mechanisms of TIC. In the literature the lethal triad of trauma (hypothermia, acidosis, and coagulopathy), dilution and hypoperfusion including the role of the protein C pathway activation are well described. Recent studies offer evidence for the mechanisms which induce TIC that include platelet dysfunction, endothelial activation/anticoagulation, hypofibrinogenaemia and hyperfibrinolysis which develop very early after traumatic injury. One of the major limitations of the current literature regarding TIC is that most data presented are associations from observational databases, and only a few prospective observational studies exist and causative aspects are only shown by haemorrhagic shock in animal models.TIC represents a complex interplay between coagulation, inflammation, and cellular dysfunction (platelets, leukocytes, and endothelium). Mechanisms include anticoagulation by the thrombin-thrombomodulin protein C system, platelet dysfunction and hyperfibrinolysis. The understanding of TIC has improved immensely in recent years but many questions remain that need to be answered by other prospective studies and animal models to further define this complex syndrome.

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Published In

Trends in Anaesthesia and Critical Care

DOI

EISSN

2210-8467

ISSN

2210-8440

Publication Date

February 1, 2015

Volume

5

Issue

1

Start / End Page

23 / 27
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Theusinger, O. M., Baulig, W., & Levy, J. H. (2015). Coagulation in trauma. Trends in Anaesthesia and Critical Care, 5(1), 23–27. https://doi.org/10.1016/j.tacc.2014.10.006
Theusinger, O. M., W. Baulig, and J. H. Levy. “Coagulation in trauma.” Trends in Anaesthesia and Critical Care 5, no. 1 (February 1, 2015): 23–27. https://doi.org/10.1016/j.tacc.2014.10.006.
Theusinger OM, Baulig W, Levy JH. Coagulation in trauma. Trends in Anaesthesia and Critical Care. 2015 Feb 1;5(1):23–7.
Theusinger, O. M., et al. “Coagulation in trauma.” Trends in Anaesthesia and Critical Care, vol. 5, no. 1, Feb. 2015, pp. 23–27. Scopus, doi:10.1016/j.tacc.2014.10.006.
Theusinger OM, Baulig W, Levy JH. Coagulation in trauma. Trends in Anaesthesia and Critical Care. 2015 Feb 1;5(1):23–27.
Journal cover image

Published In

Trends in Anaesthesia and Critical Care

DOI

EISSN

2210-8467

ISSN

2210-8440

Publication Date

February 1, 2015

Volume

5

Issue

1

Start / End Page

23 / 27