Acute traumatic coagulopathy

Andrew Cap, Beverley Hunt*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

59 Scopus citations

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.

Original languageEnglish
Pages (from-to)638-645
Number of pages8
JournalCurrent Opinion in Critical Care
Volume20
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Acute traumatic coagulopathy
  • Endothelial activation
  • Fibrinolysis
  • Hemostatic resuscitation
  • Hypoperfusion
  • Microparticles
  • Platelet dysfunction
  • Tranexamic acid
  • Viscoelastic coagulation monitoring

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