scholarly journals Evaluation of trauma‐induced coagulopathy in the fibrinogen in the initial resuscitation of severe trauma trial

Transfusion ◽  
2021 ◽  
Vol 61 (S1) ◽  
Author(s):  
Henry T. Peng ◽  
Barto Nascimento ◽  
Shawn G. Rhind ◽  
Luis Luz ◽  
Andrew Beckett
Keyword(s):  
Severe Trauma ◽  
Initial Resuscitation ◽  
Trauma Induced Coagulopathy

scholarly journals Effects of Blood Components and Whole Blood in a Model of Severe Trauma-Induced Coagulopathy

2021 ◽  
Vol 259 ◽  
pp. 55-61
Author(s):  
Gregory R. Stettler ◽  
Ernest E. Moore ◽  
Geoffrey R. Nunns ◽  
Marguerite Kelher ◽  
Anirban Banerjee ◽  
...  
Keyword(s):  
Whole Blood ◽  
Severe Trauma ◽  
Blood Components ◽  
Trauma Induced Coagulopathy

scholarly journals Trauma-induced coagulopathy: prospective observation study

2021 ◽  
pp. 29-34
Author(s):  
Mariana Vyshynska
Keyword(s):  
Venous Blood ◽  
Severe Trauma ◽  
Main Group ◽  
Control Group ◽  
Observation Study ◽  
Hemostasis System ◽  
Primary Hemostasis ◽  
Normal Number ◽  
Trauma Induced Coagulopathy ◽  
Thrombotic Complications

Coagulopathy remains the leading cause of illness and death in people with severe trauma. The aim was to study the indicators of vascular-platelet hemostasis in severe trauma and to establish changes in the main pathophysiological mechanisms of primary hemostasis that occur in patients with trauma-induced coagulopathy, compared with almost healthy individuals of the same age. Materials and methods. The study included 44 patients aged 19 to 55 years (36.1 [28.7; 43.2] years). The control group included 20 patients of the therapeutic department without preconditions for changes in the hemostasis system, and the main group - 24 patients with diagnosis of “severe trauma” who were treated in the anesthesiology and intensive care department. Results and discussion. We studied indicators of intravascular platelet activation. Patients had a normal number of platelets in the venous blood, but the level of spherocytes and spheroechinocytes increased. On the 3rd day after the injury, number of platelets in the venous blood was normal, however the level of discocytes decreased, and the level of discochinocytes, spheroechinocytes and the sum of active forms of platelets increased. On the fifth day, the level of discochinocytes and active forms of platelets, significantly higher (p<0.05) among patients of the main group, and spherocytes, spheroechinocytes and platelets involved in the aggregates, were significantly lower than in the control group of patients (p<0.05). Conclusions. Indicators of vascular-platelet hemostasis in patients with polytrauma had significant differences from those of the control group. This may be evidence of activation of the vascular-platelet system of the hemostasis system and may be a prerequisite for late thrombotic complications in patients with polytrauma

scholarly journals Tranexamic acid in trauma-induced coagulopathy

2021 ◽  
Vol 26 (80) ◽  
pp. 126-147
Author(s):  
Sanja Ratković ◽  
Adi Hadžibegović ◽  
Isidora Jovanović ◽  
Marija Rajković ◽  
Aleksandar Jovanović ◽  
...  
Keyword(s):  
At Risk ◽  
Tranexamic Acid ◽  
Cause Of Death ◽  
Severe Trauma ◽  
Massive Bleeding ◽  
Acute Traumatic Coagulopathy ◽  
Trauma Induced Coagulopathy ◽  
The Subject ◽  
Hemostatic Disorder ◽  
Traumatic Coagulopathy

Trauma is still the leading cause of death in the world among the population under the age of 45 and bleeding is the dominant cause of early mortality in one third of all injured. Coagulopathy in trauma is directly related to the outcome and is considered to be the most significant preventable cause of death. Trauma-induced coagulopathy is a complex, multifactorial disorder that can be roughly divided into three phases. The entity of acute traumatic coagulopathy is characterized as an endogenous hemostatic disorder that occurs in the first few minutes of injury associated with tissue damage caused by severe trauma and hemorrhagic shock, regardless of external factors. The pathogenesis of trauma-induced coagulopathy is not fully known and is still the subject of research. According to the latest recommendations of the European Guide for the Management of Massive Bleeding and Coagulopathy in Trauma, tranexamic acid should be used as soon as possible, and no later than three hours after the injury in a patient who is bleeding or at risk of significant bleeding. Its prehospital application should be considered. In the light of new knowledge, the question of the justification and safety of the free use of tranexamic acid in trauma has been raised. The use of tranexamic acid in trauma-induced coagulopathy is a simple and affordable therapeutic approach that should be used in the prehospital period in those patients who are bleeding or at risk of significant bleeding. The implementation of this therapy in our country has not yet come to life.

scholarly journals Goal-directed therapy in trauma induced coagulopathy and focus on traumatic brain injury

2013 ◽  
Vol 4 (3S) ◽  
pp. 17-29
Author(s):  
Klaus Görlinger
Keyword(s):  
Brain Injury ◽  
Brain Injuries ◽  
Negative Impact ◽  
Post Partum ◽  
Fixed Ratio ◽  
Severe Trauma ◽  
Coagulation Disorder ◽  
Limited Information ◽  
Trauma Induced Coagulopathy ◽  
Coagulation Tests

In recent years there have been major advances in the management of trauma-induced coagulopathy (TIC) and many experiences have demonstrated how we can achieve significant improvements with multidisciplinary approach and implementation of standardized protocols and algorithms. Central nervous system injuries and exanguination remain the primary causes of early trauma-related mortality. Traumatic brain injuries (TBI) make hemostasis in TIC even more complex and it is known that the onset of coagulopathy in a patient with severe brain injury has a negative impact on the patient’s outcome in terms of mortality. Standard coagulation tests provide limited information on coagulation disorder. The advantages of whole-blood viscoelastic tests, such as rotational thromboelastometry or thrombelastography, are shorter turn-around time and better diagnostic performance compared to routine plasmatic coagulation tests. In contrast to a fixed ratio of FFP:PC:RBC, the aim of the goal-directed coagulation therapy is to set treatment to the actual needs of the individual patient, based on viscoelastic test results. This article describes the improvements achieved through the implementation of ROTEM-guided treatment algorithms for visceral surgery and liver trasplantation, severe trauma and post-partum hemorrhage and cardiovascular surgery.

Risk factors and clinical significance of trauma-induced coagulopathy in ICU patients with severe trauma

2013 ◽  
Vol 20 (4) ◽  
pp. 286-290 ◽  
Author(s):  
Shan-Xiang Xu ◽  
Lian Wang ◽  
Guang-Ju Zhou ◽  
Mao Zhang ◽  
Jian-Xin Gan
Keyword(s):  
Risk Factors ◽  
Clinical Significance ◽  
Severe Trauma ◽  
Icu Patients ◽  
Trauma Induced Coagulopathy

The Central Role of Fibrinolytic Response in Trauma-Induced Coagulopathy: A Hematologist's Perspective

2019 ◽  
Vol 46 (02) ◽  
pp. 116-124
Author(s):  
Hau C. Kwaan
Keyword(s):  
Multiorgan Failure ◽  
Severe Trauma ◽  
Massive Hemorrhage ◽  
Fibrinolytic System ◽  
Major Focus ◽  
System A ◽  
Trauma Induced Coagulopathy ◽  
Injured Patients ◽  
Factor Release

AbstractSevere trauma is the leading cause of death globally. Though improved resuscitation, particularly early initiation, has reduced the 24-hour mortality rate, the overall morbidity and 30-day mortality remain high mostly due to massive hemorrhage and head injury in the early stages and sepsis and multiorgan failure later on. With recent clinical trials of antifibrinolytic treatment with tranexamic acid, and with the observations that fibrinolytic activity varies widely among the injured patients, the role of the fibrinolytic system in trauma has become a major focus of investigations in trauma-induced coagulopathy. Most of the body's response to trauma involves the endothelium, tissue factor release, and platelet activation. In addition, there are inflammatory and immune responses. All these events directly or indirectly affect the fibrinolytic system. A full understanding of these mechanisms has translational implications on the management of these patients. In this article, the multifaceted responses of fibrinolysis following injury are reviewed.

scholarly journals Fibrinogen in the initial resuscitation of severe trauma (FiiRST): a randomized feasibility trial

2016 ◽  
Vol 117 (6) ◽  
pp. 775-782 ◽  
Author(s):  
B. Nascimento ◽  
J. Callum ◽  
H. Tien ◽  
H. Peng ◽  
S. Rizoli ◽  
...  
Keyword(s):  
Severe Trauma ◽  
Feasibility Trial ◽  
Initial Resuscitation
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