The 'procoagulopathy' of trauma: too much, too late?

Holley, Anthony D. and Reade, Michael C. (2013) The 'procoagulopathy' of trauma: too much, too late?. Current Opinion in Critical Care, 19 6: 578-586. doi:10.1097/MCC.0000000000000032

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Author Holley, Anthony D.
Reade, Michael C.
Title The 'procoagulopathy' of trauma: too much, too late?
Journal name Current Opinion in Critical Care   Check publisher's open access policy
ISSN 1070-5295
1531-7072
Publication date 2013-12-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/MCC.0000000000000032
Volume 19
Issue 6
Start page 578
End page 586
Total pages 9
Place of publication Philadelphia, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2706 Critical Care and Intensive Care Medicine
Abstract PURPOSE OF REVIEW: Although early acute traumatic coagulopathy has received much recent attention, the procoagulopathy that often follows appears less appreciated. Thromboembolic disease following trauma is common and lethal, but very effective prophylactic strategies are available. These strategies are variably implemented because of the difficulty in quantifying the magnitude of procoagulopathy in individual patients. RECENT FINDINGS: The principal mechanisms of the procoagulopathy of trauma include inflammation and disseminated intravascular coagulation, tissue factor and thrombin dysregulation, and circulating microparticles and phospholipids. Quantification of these factors may allow better risk assessment in individual patients, but as yet none of these tests is in routine practice. Viscoelastic measurement of developing clot strength identifies a procoagulant state in many trauma patients, and may be a guide to the best choice of the many options for thromboembolic prophylaxis. SUMMARY: The logical next step following from the improved pathophysiological understanding of the procoagulopathy of trauma should be a simultaneous clinical trial of procoagulopathy diagnosis and thromboembolic prophylaxis.
Keyword Blood coagulation disorders
Disseminated intravascular coagulation
Trauma
Wounds and injuries
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Non HERDC
School of Medicine Publications
 
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