Advances in the understanding of trauma-induced coagulopathy

摘要: Ten percent of deaths worldwide are due to trauma, and it is the third most common cause death in United States. Despite a profound upregulation procoagulant mechanisms, one-quarter trauma patients present with laboratory-based evidence trauma-induced coagulopathy (TIC), which associated poorer outcomes including increased mortality. The causes after hemorrhage traumatic brain injury (TBI). management TIC has significant implications both because many hemorrhagic could be preventable, progression intracranial TBI. This review covers recent advances our understanding TIC, role platelet dysfunction, endothelial activation, fibrinolysis. Trauma induces plethora biochemical physiologic changes, despite numerous studies reporting differences coagulation parameters between uninjured controls, unclear whether some these may “normal” trauma. Comparisons differing use animal have shed light on this issue, but much data continue correlative causative links lacking. In particular, there little linking abnormalities true clinically evident coagulopathic bleeding. For reasons, continues diagnostic therapeutic challenge.