Acute Traumatic Coagulopathy

Abstract

Purpose of review Mortality from trauma remains a global public health challenge, with most preventable deaths due to bleeding. The recognition of acute traumatic coagulopathy as a distinct clinical entity characterized by early coagulation dysfunction, arising prior to medical intervention, has revolutionized trauma management over the last decade. The aim of this article is to review our current understanding of acute traumatic coagulopathy. Recent findings We focus on recent advances in the mechanistic understanding of acute traumatic coagulopathy, particularly the changes in coagulation factors, physiological anticoagulants, endothelial activation, fibrinolysis and platelet dysfunction. Evolving diagnostic and therapeutic approaches are discussed, including viscoelastic coagulation monitoring and the role of tranexamic acid and blood products. Summary Emphasis is now placed on early prevention, diagnosis, and aggressive initial treatment of coagulopathy and fibrinolysis with haemostatic blood products and tranexamic acid in addition to red cell units in order to reduce bleeding and improve clinical outcomes.

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Document Details

Document Type
Technical Report
Publication Date
Dec 01, 2014
Accession Number
ADA614493

Entities

People

  • Andrew P Cap
  • Beverley Hunt

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Anticoagulants
  • Blood
  • Blood Coagulation
  • Blood Coagulation Factors
  • Blood Transfusions
  • Brain Injuries
  • Cells
  • Combat Casualty Care
  • Combat Support Hospitals
  • Health Services
  • Hematologic Diseases
  • Hemorrhage
  • Hemorrhagic Shock
  • Protein C
  • Proteins
  • Public Health
  • Therapy

Fields of Study

  • Medicine

Readers

  • Distributed Systems and Data Platform Development
  • Immunology
  • Trauma or Military Medicine