Coagulopathy of Trauma

Mitchell J Cohen; S Ariane Christie

doi:10.1016/j.ccc.2016.08.003

Coagulopathy of Trauma

Crit Care Clin. 2017 Jan;33(1):101-118. doi: 10.1016/j.ccc.2016.08.003.

Authors

Mitchell J Cohen¹, S Ariane Christie²

Affiliations

¹ Department of Surgery, San Francisco General Hospital, University of California, San Francisco, School of Medicine, 1001 Potrero Avenue, San Francisco, CA 94110, USA. Electronic address: Mitchell.Cohen@ucsf.edu.
² Department of Surgery, San Francisco General Hospital, University of California, San Francisco, School of Medicine, 1001 Potrero Avenue, San Francisco, CA 94110, USA.

PMID: 27894491
DOI: 10.1016/j.ccc.2016.08.003

Abstract

Coagulopathy is common after injury and develops independently from iatrogenic, hypothermic, and dilutional causes. Despite considerable research on the topic over the past decade, trauma-induced coagulopathy (TIC) continues to portend poor outcomes, including decreased survival. We review the current evidence regarding the diagnosis and mechanisms underlying trauma induced coagulopathy and summarize the debates regarding optimal management strategy including product resuscitation, potential pharmacologic adjuncts, and targeted approaches to hemostasis. Throughout, we will identify areas of continued investigation and controversy in the understanding and management of TIC.

Keywords: Bleeding; Coagulation; Coagulopathy; Hemorrhage; Targeted resuscitation; Trauma; Trauma-induced coagulopathy.

Publication types

Review

MeSH terms

Blood Coagulation Disorders / etiology*
Blood Coagulation Disorders / therapy*
Hemorrhage / etiology*
Hemorrhage / therapy*
Humans
Wounds and Injuries / complications*
Wounds and Injuries / diagnosis
Wounds and Injuries / therapy*