Pathogenesis of acute traumatic coagulopathy

摘要: Acute traumatic coagulopathy (ATC) is an early endogenous process, driven by the combination of tissue injury and shock that associated with increased mortality worse outcomes in polytrauma patient. This review summarizes our current understanding pathophysiology ATC role rapid diagnostics management severe trauma hemorrhage. In particular we consider diagnostic therapeutic strategies for bleeding patients short versus long prehospital times concept remote damage control resuscitation. Endothelial activation Protein C a central mechanism ATC, which produces anticoagulation fibrinolysis following trauma. Continued blood loss, hypothermia, acidosis, hemodilution potentiate lead to global derangement all components hemostasis. The contribution interplay between platelet activity, fibrinogen utilization, endothelial dysfunction, neurohormonal pathways remain be defined pathogenesis but may offer novel targets. Conventional laboratory-based tests coagulation have limited major TEG ROTEM provide evaluation clot dynamics whole are greater value than screens diagnosing managing