• Dtsch Arztebl Int · Dec 2011

    Review Meta Analysis

    Acute traumatic coagulopathy in severe injury: incidence, risk stratification, and treatment options.

    • Marc Maegele, Thomas Paffrath, and Bertil Bouillon.
    • Klinik für Unfallchirurgie, Orthopädie und Sporttraumatologie, Kliniken der Stadt Köln gGmbH. Marc.Maegele@t-online.de
    • Dtsch Arztebl Int. 2011 Dec 1;108(49):827-35.

    BackgroundClinical observation and research findings show that acute traumatic coagulopathy (ATC) is a major factor that must be addressed in the care of severely injured patients. In this review article, we discuss the incidence and causes of ATC, the potential means of early risk stratification for it, and recommendations for its treatment.MethodsWe selectively reviewed the pertinent literature and retrospectively analyzed data from the Trauma Registry of the German Trauma Society (Traumaregister der Deutschen Gesellschaft für Unfallchirurgie, TR-DGU) relating to the incidence, causes, and outcome of ATC. We provide an overview of current treatment recommendations, supplemented by our own findings regarding the ratio of packed red blood cell concentrate (pRBC) to fresh-frozen plasma (FFP) transfusion and regarding coagulation-factor-based treatments for coagulopathy in the acute phase after trauma.Results And ConclusionATC, a condition associated with increased morbidity and mortality, is seen on admission in one out of four patients with major trauma. The main causes of ATC are tissue damage, hypoperfusion, hemodilution, hypothermia, acidosis, and inflammation. It may be possible to identify patients at risk for ATC early on through the use of rapidly calculable, predictive numerical scales (McLaughlinScore, TASH, and ABC), laboratory tests, and imaging studies (FAST and CT). Acute treatment is focused on the control of bleeding and support of the coagulation system according to the current guidelines. Patients at high risk may benefit from a balanced transfusion strategy. Innovative strategies currently under study include point-of-care-guided treatment and coagulation-factor-concentrate-based treatment.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.