Coagulopathy in the trauma patient

    Research output: Contribution to journalArticle

    94 Citations (Scopus)

    Abstract

    Purpose of review: Homeostasis represents a delicate balance between hemostatic and fibrinolytic processes. This balance permits arrest of hemorrhage after mild injury but prevents thrombosis from occurring under normal circumstances. Trauma disturbs the equilibrium between hemostatic and fibrinolytic processes, frequently producing either a hypocoagulable state or a hypercoagulable state depending on the severity of injury, degree of hemorrhage, and the nature of the resuscitation. The purpose of this review is to describe the epidemiology and pathophysiology of coagulopathy after trauma and to discuss novel methods of treating it. Recent findings: Published reports during the past year focus on the pathophysiology of coagulopathy after trauma and novel methods of treatment. Individual effects of hypothermia and acidosis on clotting factors and platelet function have been described. The effects of varying resuscitation fluids on coagulopathy have also been described as well as the course of coagulopathy over time. Recombinant factor VIIa has emerged as a popular therapy for traumatic coagulopathy although a prospective randomized trial has yet to be published. The efficacy of several new dressings for the local control of hemorrhage has been reported. Summary: Changes in coagulation following trauma are characterized by a complex series of events that may result in either a hypocoagulable or a hypercoagulable state. Routinely analyzed coagulation parameters do not adequately describe this state and they are deficient for guiding its therapy. Several promising new agents are available for treating hemorrhage in coagulopathic trauma patients that should result in improved survival.

    Original languageEnglish (US)
    Pages (from-to)590-597
    Number of pages8
    JournalCurrent Opinion in Critical Care
    Volume11
    Issue number6
    DOIs
    StatePublished - Dec 2005

    Fingerprint

    Wounds and Injuries
    Hemorrhage
    Hemostatics
    Resuscitation
    Blood Coagulation Factors
    Bandages
    Acidosis
    Hypothermia
    Epidemiology
    Thrombosis
    Homeostasis
    Therapeutics
    Blood Platelets
    Survival

    Keywords

    • Coagulopathy
    • Hemostatic bandages
    • Recombinant factor VIIa
    • Resuscitation
    • Trauma

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine

    Cite this

    Coagulopathy in the trauma patient. / Schreiber, Martin.

    In: Current Opinion in Critical Care, Vol. 11, No. 6, 12.2005, p. 590-597.

    Research output: Contribution to journalArticle

    @article{1034e040250449898a3815685d3db105,
    title = "Coagulopathy in the trauma patient",
    abstract = "Purpose of review: Homeostasis represents a delicate balance between hemostatic and fibrinolytic processes. This balance permits arrest of hemorrhage after mild injury but prevents thrombosis from occurring under normal circumstances. Trauma disturbs the equilibrium between hemostatic and fibrinolytic processes, frequently producing either a hypocoagulable state or a hypercoagulable state depending on the severity of injury, degree of hemorrhage, and the nature of the resuscitation. The purpose of this review is to describe the epidemiology and pathophysiology of coagulopathy after trauma and to discuss novel methods of treating it. Recent findings: Published reports during the past year focus on the pathophysiology of coagulopathy after trauma and novel methods of treatment. Individual effects of hypothermia and acidosis on clotting factors and platelet function have been described. The effects of varying resuscitation fluids on coagulopathy have also been described as well as the course of coagulopathy over time. Recombinant factor VIIa has emerged as a popular therapy for traumatic coagulopathy although a prospective randomized trial has yet to be published. The efficacy of several new dressings for the local control of hemorrhage has been reported. Summary: Changes in coagulation following trauma are characterized by a complex series of events that may result in either a hypocoagulable or a hypercoagulable state. Routinely analyzed coagulation parameters do not adequately describe this state and they are deficient for guiding its therapy. Several promising new agents are available for treating hemorrhage in coagulopathic trauma patients that should result in improved survival.",
    keywords = "Coagulopathy, Hemostatic bandages, Recombinant factor VIIa, Resuscitation, Trauma",
    author = "Martin Schreiber",
    year = "2005",
    month = "12",
    doi = "10.1097/01.ccx.0000186374.49320.ab",
    language = "English (US)",
    volume = "11",
    pages = "590--597",
    journal = "Current Opinion in Critical Care",
    issn = "1070-5295",
    publisher = "Lippincott Williams and Wilkins",
    number = "6",

    }

    TY - JOUR

    T1 - Coagulopathy in the trauma patient

    AU - Schreiber, Martin

    PY - 2005/12

    Y1 - 2005/12

    N2 - Purpose of review: Homeostasis represents a delicate balance between hemostatic and fibrinolytic processes. This balance permits arrest of hemorrhage after mild injury but prevents thrombosis from occurring under normal circumstances. Trauma disturbs the equilibrium between hemostatic and fibrinolytic processes, frequently producing either a hypocoagulable state or a hypercoagulable state depending on the severity of injury, degree of hemorrhage, and the nature of the resuscitation. The purpose of this review is to describe the epidemiology and pathophysiology of coagulopathy after trauma and to discuss novel methods of treating it. Recent findings: Published reports during the past year focus on the pathophysiology of coagulopathy after trauma and novel methods of treatment. Individual effects of hypothermia and acidosis on clotting factors and platelet function have been described. The effects of varying resuscitation fluids on coagulopathy have also been described as well as the course of coagulopathy over time. Recombinant factor VIIa has emerged as a popular therapy for traumatic coagulopathy although a prospective randomized trial has yet to be published. The efficacy of several new dressings for the local control of hemorrhage has been reported. Summary: Changes in coagulation following trauma are characterized by a complex series of events that may result in either a hypocoagulable or a hypercoagulable state. Routinely analyzed coagulation parameters do not adequately describe this state and they are deficient for guiding its therapy. Several promising new agents are available for treating hemorrhage in coagulopathic trauma patients that should result in improved survival.

    AB - Purpose of review: Homeostasis represents a delicate balance between hemostatic and fibrinolytic processes. This balance permits arrest of hemorrhage after mild injury but prevents thrombosis from occurring under normal circumstances. Trauma disturbs the equilibrium between hemostatic and fibrinolytic processes, frequently producing either a hypocoagulable state or a hypercoagulable state depending on the severity of injury, degree of hemorrhage, and the nature of the resuscitation. The purpose of this review is to describe the epidemiology and pathophysiology of coagulopathy after trauma and to discuss novel methods of treating it. Recent findings: Published reports during the past year focus on the pathophysiology of coagulopathy after trauma and novel methods of treatment. Individual effects of hypothermia and acidosis on clotting factors and platelet function have been described. The effects of varying resuscitation fluids on coagulopathy have also been described as well as the course of coagulopathy over time. Recombinant factor VIIa has emerged as a popular therapy for traumatic coagulopathy although a prospective randomized trial has yet to be published. The efficacy of several new dressings for the local control of hemorrhage has been reported. Summary: Changes in coagulation following trauma are characterized by a complex series of events that may result in either a hypocoagulable or a hypercoagulable state. Routinely analyzed coagulation parameters do not adequately describe this state and they are deficient for guiding its therapy. Several promising new agents are available for treating hemorrhage in coagulopathic trauma patients that should result in improved survival.

    KW - Coagulopathy

    KW - Hemostatic bandages

    KW - Recombinant factor VIIa

    KW - Resuscitation

    KW - Trauma

    UR - http://www.scopus.com/inward/record.url?scp=28144448490&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=28144448490&partnerID=8YFLogxK

    U2 - 10.1097/01.ccx.0000186374.49320.ab

    DO - 10.1097/01.ccx.0000186374.49320.ab

    M3 - Article

    C2 - 16292065

    AN - SCOPUS:28144448490

    VL - 11

    SP - 590

    EP - 597

    JO - Current Opinion in Critical Care

    JF - Current Opinion in Critical Care

    SN - 1070-5295

    IS - 6

    ER -