Damage Control Resuscitation
Abstract
While the vast majority of bleeding trauma patients who arrive in emergency departments are either hypercoagulable or only slightly injured with normal coagulation parameters, a small segment of trauma patients (10%) are hypocoagulable. This small segment of severely injured patients comprises the majority of in-hospital trauma deaths. They are frequently hypothermic with acidosis and hypothermia-induced coagulation factor and platelet dysfunction, combined with coagulation factor consumption, and culminating in a profound coagulopathy. The most severely injured are more coagulopathic. Though it has long been recognized that the lethal triad of hypothermia, acidosis and coagulopathy is associated with a significant increase in mortality, coagulopathy has been viewed as a byproduct of resuscitation, hemodilution and hypothermia. We know now that coagulatpathy is in fact present on admission.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2007
- Accession Number
- ADA627816
Entities
People
- John B Holcomb
Organizations
- United States Army Institute of Surgical Research